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Taradaj J1,2,3, Walewicz K4
1Academy of Physical Education, Physiotherapy Basics, Katowice, Poland, 2University of Manitoba, College of Rehabilitation Sciences, Winnipeg, Canada, 3Polish Chamber of Physiotherapists, Warsaw, Poland, 4Public Higher Professional Medical School, Faculty of Physiotherapy, Opole, Poland
Background: The management of lymphedema is an extremely important clinical, social and economic problem. It is upsetting that despite the enormous technological advances in medicine that have taken place over the last decades, there is still unsatisfactory effective, affordable, and versatile method of physiotherapy for every patient with lymphedema (without many contraindications and limitations). The use of KT in the treatment of lymphedema still stimulates a lot of controversy. On the one hand, it is a simple and popular tool in everyday clinical practice, on the other hand, the level of scientific evidence is unclear.
Purpose: To present the RCT (trial ID: ACTRN12613001173785) on effect of KT on the size of lymphedema and manual dexterity of the upper limb in women after breast cancer treatment and compare our results to data from literature.
Methods: In RCT group A comprised of 30 patients who underwent KT as well as pneumatic (45 minutes, once a day, three times a week, 12-chamber device, 60 mmHg in the first week, in the second week 70, and 80 and 90 mmHg third and fourth week respectively) and manual lymphatic drainage (50 minutes, once a day, three times a week). Then, group B comprised of 28 patients who were treated with quasi-KT (sham therapy) as well as pneumatic and manual lymphatic drainage - identically as in group A (randomized single-blind controlled study). Patient evaluation items included limb size (optoelectronic Perometer 400 T), grip strength (hand dynamometer) and range of motion (goniometric measurement). A search for systematic review was performed in electronic databases (MEDLINE, Embase, PubMed, Cochrane Library, and PEDro) for studies published up to June 2018 using the following keywords: lympedema, lymphoedema, breast cancer, Kinesio taping, KT, Kinesiology taping and tape.
Results: Both after 4-week therapy and 3 month follow-up, we observed that KT is not an effective method of reducing lymphedema II and III stage in women after breast cancer
treatment. We observed in both groups the statistically significant decrease in the volume of the impaired limb in comparison to the initial size. However, the analysis of variance shows that there has been no difference between group A vs. B. Similarly, situation occurred in terms of grip test and range of motion measurements. In our systematic review we found 76 studies, but only 5 publications fulfilled the inclusion criteria (three were very critical, two promising). The PEDro scale score was only 4.21 points.
Conclusion(s): At this moment, the KT cannot replace the traditional and standard multilayered bandaging in the treatment of upper extremity lymphedema. Based on current literature the level of evidence is relatively weak.
Implications: The lack of knowledge due to Evidence Based Medicine rules of the effects of KT on breast cancer-related lymphedema significantly hinders the use of this method in physiotherapy clinical practice. Without high level scientific recommendations the based on well conducted RCTs, metaanalyses and Cochrane reports, it is difficult to substantiate the use of KT application in hospital or outpatient settings in patients with lymphedema. That is the exremely important area both for researchers and therapists.
Keywords: kinesio taping, breast cancer, lymphedema
Funding acknowledgements: Polish Society of Lymphology (grant no. PTL/1/2015)
Purpose: To present the RCT (trial ID: ACTRN12613001173785) on effect of KT on the size of lymphedema and manual dexterity of the upper limb in women after breast cancer treatment and compare our results to data from literature.
Methods: In RCT group A comprised of 30 patients who underwent KT as well as pneumatic (45 minutes, once a day, three times a week, 12-chamber device, 60 mmHg in the first week, in the second week 70, and 80 and 90 mmHg third and fourth week respectively) and manual lymphatic drainage (50 minutes, once a day, three times a week). Then, group B comprised of 28 patients who were treated with quasi-KT (sham therapy) as well as pneumatic and manual lymphatic drainage - identically as in group A (randomized single-blind controlled study). Patient evaluation items included limb size (optoelectronic Perometer 400 T), grip strength (hand dynamometer) and range of motion (goniometric measurement). A search for systematic review was performed in electronic databases (MEDLINE, Embase, PubMed, Cochrane Library, and PEDro) for studies published up to June 2018 using the following keywords: lympedema, lymphoedema, breast cancer, Kinesio taping, KT, Kinesiology taping and tape.
Results: Both after 4-week therapy and 3 month follow-up, we observed that KT is not an effective method of reducing lymphedema II and III stage in women after breast cancer
treatment. We observed in both groups the statistically significant decrease in the volume of the impaired limb in comparison to the initial size. However, the analysis of variance shows that there has been no difference between group A vs. B. Similarly, situation occurred in terms of grip test and range of motion measurements. In our systematic review we found 76 studies, but only 5 publications fulfilled the inclusion criteria (three were very critical, two promising). The PEDro scale score was only 4.21 points.
Conclusion(s): At this moment, the KT cannot replace the traditional and standard multilayered bandaging in the treatment of upper extremity lymphedema. Based on current literature the level of evidence is relatively weak.
Implications: The lack of knowledge due to Evidence Based Medicine rules of the effects of KT on breast cancer-related lymphedema significantly hinders the use of this method in physiotherapy clinical practice. Without high level scientific recommendations the based on well conducted RCTs, metaanalyses and Cochrane reports, it is difficult to substantiate the use of KT application in hospital or outpatient settings in patients with lymphedema. That is the exremely important area both for researchers and therapists.
Keywords: kinesio taping, breast cancer, lymphedema
Funding acknowledgements: Polish Society of Lymphology (grant no. PTL/1/2015)
Topic: Oncology, HIV & palliative care; Older people; Outcome measurement
Ethics approval required: Yes
Institution: Academy of Physical Education
Ethics committee: The Research Ethics Committee
Ethics number: 1605/12/2012
All authors, affiliations and abstracts have been published as submitted.
