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Kurt G, Kiloatar H, Aras B. Knowledge, attitude and practice of physiotherapists about lymphedema: A Turkish perspective. J Bodyw Mov Ther 2024; 37:233-237. [PMID: 38432811 DOI: 10.1016/j.jbmt.2023.11.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/17/2023] [Accepted: 11/26/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND Physiotherapists are important members of the healthcare team in the management of lymphedema. Therefore, the level of knowledge and awareness of physiotherapists on this disease is substantial. This study was planned to investigate knowledge, attitude, and practice of physiotherapists about lymphedema in Turkey. METHOD This study was a qualitative, prospective, and cross-sectional research. Data were collected with the web-survey which consisted of the demographical characteristics information, evaluation of their own knowledge and practice in lymphedema management, and current knowledge of physiotherapists about lymphedema based on the current literature. RESULTS Two hundred seventy-four physiotherapists (174 Female: 100 Male; mean age: 29.87 ± 6.9 years) completed the web-survey. From 274 physiotherapists, 52.60% of them had no education about lymphedema, 13.90% of them had never seen any patient with lymphedema, and 57.70% of them had not taken part in the management of a patient with lymphedema. 71.90% of the physiotherapists did not think they have enough knowledge about lymphedema. It was identified that physiotherapists' general and risk factors knowledge about lymphedema was sufficient. However, physiotherapists showed a lack of knowledge on the evaluation, treatment, and recommendations for lymphedema. CONCLUSION Physiotherapists' education and experience in lymphedema management are crucial as they are important members of the multidisciplinary team. To raise qualified physiotherapists in this field, from undergraduate education, special training programs about lymphedema should be added to their lifelong learning process.
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Affiliation(s)
- Gamze Kurt
- Department of Occupational Therapy, Kutahya Health Sciences University, Kutahya, Turkey.
| | - Humeyra Kiloatar
- Department of Physiotherapy and Rehabilitation, Kutahya Health Sciences University, Kutahya, Turkey.
| | - Bahar Aras
- Department of Physiotherapy and Rehabilitation, Kutahya Health Sciences University, Kutahya, Turkey.
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Rhodes CA, Brandt C, Keller M. Physiotherapy practice in lymphoedema in South Africa: A survey. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2023; 79:1907. [PMID: 37928646 PMCID: PMC10623631 DOI: 10.4102/sajp.v79i1.1907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/31/2023] [Indexed: 11/07/2023] Open
Abstract
Background Lymphoedema is a chronic condition that is increasing in prevalence and requires specialised management to avoid possible life-threatening complications. Objectives To describe the perceived knowledge of physiotherapists about lymphoedema and its management, the lymphoedema patient load seen by physiotherapists, and the current treatment approaches of physiotherapists in South Africa when managing lymphoedema. Method A quantitative study using self-administered, online questionnaires were distributed among physiotherapists. Results Knowledge of lymphoedema management is perceived to be lacking among physiotherapists. Physiotherapists are getting limited referrals and spending little time managing patients with lymphoedema. Only a few physiotherapists have post-graduate education in lymphoedema management, thus international treatment standards still need to be met. Conclusion In order to meet international standards and patient needs, future research investigating the physiotherapy perspective is needed in lymphoedema management. Clinical implications Educational bodies and policymakers may use this data to facilitate improvement in physiotherapy management of the condition and provision of care.
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Affiliation(s)
- Carys A Rhodes
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Corlia Brandt
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Monique Keller
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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3
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Asséré YAGRA, Kaba L, Assi-Dje Bi Dje V, Akpro LR. [Elephantiasis of the lower limb: Treatment of seven cases using the modified Charles technique]. ANN CHIR PLAST ESTH 2023; 68:354-360. [PMID: 35927107 DOI: 10.1016/j.anplas.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 06/14/2022] [Accepted: 06/23/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Lymphedema is an obstructive dysfunction of the lymphatic system characterised by an inability of the lymphatic system to eliminate excess lymphatic load. It can be congenital or secondary. Untreated, it progresses in three stages, the final stage being elephantiasis. We report a short series of 7 cases of elephantiasis of the lower limb treated with the Charles technique. Our aim was to describe the results of the surgical treatment. METHOD This was a retrospective descriptive and analytical study from January 2010 to December 2020. Patients with at least one lower limb elephantiasis of any aetiology of any age and gender who underwent excisional surgery with a complete medical record containing clinical and therapeutic data were included. RESULTS During the study period, we received 710 patients with a prevalence of elephantiasis of 1.69%. The mean age was 43.3±14.5years with a male predominance. No etiology or co-morbidity factors (diabetes, hypertension, VRS) were found. In our mini-series, the average time between the two procedures was 34.3±9.6days. The mean time to healing was 82.3±15.1days. All patients healed with two excellent results. CONCLUSION excisional surgery with two-stage repair combined with compression therapy gave satisfactory results.
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Affiliation(s)
- Y A G R A Asséré
- Service de chirurgie réparatrice, plastique et de la main de l'Institut Raoul Follereau Adzopé, Cote d'Ivoire.
| | - L Kaba
- Service de chirurgie réparatrice, plastique et de la main de l'Institut Raoul Follereau Adzopé, Cote d'Ivoire.
| | - V Assi-Dje Bi Dje
- Service de chirurgie plastique, de la main et brulologie du CHU de Treichville, Abidjan.
| | - L R Akpro
- Service de traumatologie-orthopédie et chirurgie réparatrice du CHU de Bouaké.
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Kim Y, Kim S, Lim JY, Hwang CM, Ko MH, Hwang JH. Home-Based Intermittent Pneumatic Compression Therapy: The Impact in Chronic Leg Lymphedema in Patients Treated for Gynecologic Cancer. Healthcare (Basel) 2022; 10:healthcare10040638. [PMID: 35455817 PMCID: PMC9032801 DOI: 10.3390/healthcare10040638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 02/04/2023] Open
Abstract
We conducted a prospective study of cancer patients to investigate the efficacy, quality of life, satisfaction, and safety of a home-based intermittent pneumatic compression (IPC) device during the maintenance phase of lower extremity lymphedema. This device has a unique mode designed to mimic the manual lymphatic drainage (MLD) technique and thereby gently facilitate lymphatic draining of proximal extremities. Thirty patients with stage 3 chronic secondary unilateral leg lymphedema in the maintenance phase underwent IPC and conventional compression therapy for 4 weeks at home. The participants were guided to use 1 h course (30 min of MLD-mimicking mode and 30 min of conventional mode) of IPC device twice a day for 4 weeks. We assessed the patients’ limb-volume measurement, quality of life (QOL), and satisfaction four times. There were no significant time-dependent interactions in the inter-limb volume difference ratio (Vratio). In a subgroup analysis, participants who used the home-based IPC device and maintained their routine self-maintenance program of short-stretch bandages (group B, n = 21) showed a more significant decline in Vratio than those who did not maintained their routine care (group A, n = 9). All scores of QOL decreased significantly after the intervention without subgroup difference. All participants were satisfied with the 4-week intervention. This study demonstrated that a home-based IPC device with an MLD-mimicking program is a useful option for maintaining the volume of limbs and improving the QOL of patients with stage 3 chronic leg lymphedema during the maintenance phase.
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Affiliation(s)
- Yoon Kim
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Korea;
- Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul 01022, Korea
| | - Seonghee Kim
- Research Institute for Future Medicine, Samsung Medical Center, Seoul 06351, Korea; (S.K.); (C.M.H.)
| | - Ji Young Lim
- Department of Physical Therapy, Graduate School of Medical Sciences, Konyang University, Daejeon 35365, Korea;
| | - Chea Min Hwang
- Research Institute for Future Medicine, Samsung Medical Center, Seoul 06351, Korea; (S.K.); (C.M.H.)
| | - Myoung-Hwan Ko
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju 54907, Korea;
| | - Ji Hye Hwang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Korea;
- Correspondence: ; Tel.: +82-2-3410-2816; Fax: +82-2-3410-2820
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Carretti G, Mirandola D, Maestrini F, Sequi L, Germano S, Muraca MG, Miccinesi G, Manetti M, Marini M. Quality of life improvement in breast cancer survivors affected by upper limb lymphedema through a novel multiperspective physical activity methodology: a monocentric pilot study. Breast Cancer 2022; 29:437-449. [PMID: 35025064 DOI: 10.1007/s12282-021-01322-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 12/05/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Chronic lymphedema causes psychophysical sequelae jeopardizing quality of life (QoL) of breast cancer (BC) survivors, and lack of effective therapies represents a major challenge for healthcare professionals. Structured adapted physical activity (APA) may represent an effective strategy to attenuate cancer treatment-related impairments and improve QoL. Here, we describe the effects of a specific APA intervention based on a novel multiperspective methodology in counteracting lymphedema-related morphofunctional alterations and improving QoL of BC survivors. METHODS BC survivors with chronic moderate/severe lymphedema attending the Cancer Rehabilitation Center in Florence were assessed before and after 8-week APA. The protocol consisted of both APA specialist-supervised and self-leaded sessions using a tailor-designed proprioceptive board. Body mass index, bioimpedance parameters, indirect upper limb volume measurement, and ultrasonography were performed. Wrist flexion/extension and hand strength functional tests were also executed. QoL, depression/anxiety and pain intensity were evaluated by ULL27, HADS, distress thermometer and NRS questionnaires, respectively. RESULTS Although bioimpedance, ultrasound and volumetric measures remained mostly unchanged, wrist mobility, pain perception, depression, and QoL were all significantly ameliorated after APA. CONCLUSIONS Our findings suggest that a multidisciplinary treatment approach involving APA professionals should be employed in the management of BC-related lymphedema to improve patient psychophysical outcomes and QoL.
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Affiliation(s)
- Giuditta Carretti
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Daniela Mirandola
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, Largo Brambilla 3, 50134, Florence, Italy.,The Italian League Against Tumors (LILT), 50126, Florence, Italy
| | | | - Lisa Sequi
- The Italian League Against Tumors (LILT), 50126, Florence, Italy
| | - Sara Germano
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Maria Grazia Muraca
- Oncological Rehabilitation Centre (Ce.Ri.On.), 50139, Florence, Italy.,Oncological Network, Prevention and Research Institute (ISPRO), 50139, Florence, Italy
| | - Guido Miccinesi
- Oncological Network, Prevention and Research Institute (ISPRO), 50139, Florence, Italy
| | - Mirko Manetti
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Mirca Marini
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, Largo Brambilla 3, 50134, Florence, Italy.
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Omar MTA, Al-Dhwayan NM, Gwada RFM, Armer JM. Lymphedema rehabilitation: Provision and practice patterns among service providers: National survey. Int Wound J 2021; 19:339-350. [PMID: 34075723 PMCID: PMC8762547 DOI: 10.1111/iwj.13634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/23/2021] [Accepted: 05/25/2021] [Indexed: 02/05/2023] Open
Abstract
Information on the current practices and quantification of lymphedema service may be beneficial to promote and improve the current health care system. Therefore, this study aimed to describe the characteristics of lymphedema practitioners, and lymphedema patients' profiles, and provide a comprehensive picture of lymphedema service provision in Saudi Arabia. A cross‐sectional study design used an online survey to gather data. The survey included information about demographic and professional characteristics of lymphedema practitioners, lymphedema profiles, questions on the services provided, and perceived barriers in providing services. Eighteen lymphedema practitioners (38%) responded to the survey. Most of the respondents were physical therapists (94%), who had completed 135 hours of basic training course, and were certified as lymphedema therapists (89%). Most of these practitioners were in Riyadh (58%), Jeddah (25%), and Dammam (17%). About 75% of patients seen by practitioners had secondary lymphedema, predominately breast cancer‐related lymphedema (47%). The average number of lymphedema practitioners per service is three. The perceived barriers reported included an inadequate number of certified therapists (100%), difficulties with transportation and lack of financial support (each; 72%), and limited space for lymphedema practice/management (89%). The results suggest lymphedema practitioners provide reasonable services for lymphedema patients; however, services are still limited and needs are unmet. Therefore, more staffing is required to promote awareness of the condition and related services, to develop and implement appropriate educational strategies, and improve geographical and multidisciplinary coordination of the services in Saudi Arabia.
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Affiliation(s)
- Mohammed T A Omar
- Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,Physical Therapy Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Nouf M Al-Dhwayan
- Physical Therapy Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Rehab F M Gwada
- Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,Physical Therapy Department, National Heart Institute, Giza, Egypt
| | - Jane M Armer
- University of Missouri, Sinclair School of Nursing, Columbia, Missouri, USA
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Puszczalowska-Lizis E, Flak K, Biskup M, Zak M. Physical Activity of Women After Radical Unilateral Mastectomy and Its Impact on Overall Quality of Life. Cancer Control 2020; 27:1073274819900407. [PMID: 32003236 PMCID: PMC7003178 DOI: 10.1177/1073274819900407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Radical unilateral mastectomy is an acknowledged source of traumatic experience for women, adversely affecting their behavioral and emotional paradigm. The present study aimed to assess the quality of life in physically active and inactive postmastectomy women. Population sample involved 100 women, aged 50 to 60 years, having undergone radical unilateral mastectomy, allocated into 2 groups, upon assumption of undertaking physical activity. The abbreviated version of WHOQOL-BREF questionnaire was a research tool of choice. The data were analyzed with the aid of χ2 test, Kruskal-Wallis test, and Mann-Whitney U test. Statistically significant dependence was established between physical activity actually pursued and self-assessment of overall quality of life (P = .014) and overall the self-rated perception of health (P < .001). In the group of physically inactive women, physical health was a variable dependent upon individual level of education (P = .031). The highest scores in this domain were noted in the women boasting secondary education, whereas the lowest in the ones with vocational education. Social domain was the highest rated aspect of quality of life in both the physically active and inactive postmastectomy women, while the physical health domain was rated the lowest. Both in the case of physically active and inactive postmastectomy women, the quality of life in the respective domains, as listed in the WHOQOL-BREF questionnaire, was found independent of the living environment.
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Affiliation(s)
| | - Kinga Flak
- Non-Public Physiotherapy Practice, Jaroslaw, Poland
| | - Malgorzata Biskup
- Department of Rehabilitation, Holycross Cancer Centre, Kielce, Poland.,Faculty of Medicine and Health Sciences, Institute of Physiotherapy, The Jan Kochanowski University, Kielce, Poland
| | - Marek Zak
- Faculty of Medicine and Health Sciences, Institute of Physiotherapy, The Jan Kochanowski University, Kielce, Poland
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8
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Factors associated with professional healthcare advice seeking in breast cancer–related lymphedema. J Surg Oncol 2019; 121:67-74. [DOI: 10.1002/jso.25523] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 05/04/2019] [Indexed: 11/07/2022]
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9
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Lymphedema diagnosis, treatment, and follow-up from the view point of physical medicine and rehabilitation specialists. Turk J Phys Med Rehabil 2018; 64:179-197. [PMID: 31453511 DOI: 10.5606/tftrd.2018.3539] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 08/31/2018] [Indexed: 12/20/2022] Open
Abstract
Lymphedema is an incurable, debilitating and progressive condition, leading to physical and psychosocial consequences for the patients, if left untreated. The Physical Medicine and Rehabilitation (PMR) specialist is responsible for the differential diagnosis and evaluation of the patient to tailor management and rehabilitation strategies. Therefore, the PMR specialist must have knowledge and education on the diagnosis of disease and possible complications as well as evaluation, treatment and follow-up of the patient. In this review, the pathophysiology, epidemiology, and diagnostic and therapeutic approaches of lymphedema as well as preventive strategies and follow-up strategies are discussed in the light of the current literature.
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Schulze H, Nacke M, Gutenbrunner C, Hadamitzky C. Worldwide assessment of healthcare personnel dealing with lymphoedema. HEALTH ECONOMICS REVIEW 2018; 8:10. [PMID: 29663122 PMCID: PMC5901432 DOI: 10.1186/s13561-018-0194-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 04/03/2018] [Indexed: 05/29/2023]
Abstract
BACKGROUND Lymphoedema is a pandemic with about 250 million people suffering from this condition worldwide. Lymphatic diseases have considerable public health significance, but yet few professionals are specialised in their management causing a substantial burden on health resources. AIMS AND OBJECTIVES This study aims to give an overview of the approximate number of medical professionals, professional societies, institutions and companies dealing with lymphoedema in various countries. Concepts of improvement for current human resources are considered. METHODS An online database analysis (Google search engine and PubMed) was carried out for each country of the world. Additionally, relevant congress participant lists as well as member lists of significant medical societies and reports of the World Health Organisation were analysed. RESULTS Overall distribution of tertiary level professionals specialised in this field is heterogenous. A decrescent gradient of professionals can be seen between developed and developing countries and between urban and rural areas. Countries in general do not seem to have yet met the current demand for specialists at tertiary level in this field. CONCLUSIONS This study intends to draw attention to the current medical coverage gaps due to a low number of lymphoedema specialists at tertiary level. It wishes to start a discussion about structured reimbursement and certification of knowledge and skills that are essential incentives for experts to act as multiplicators and change the lack of care in the mid-term. Current fail prescriptions and evitable disability and sick certificates represent a high financial burden that could be reinvested in a correct management. Policy makers must focus in the two above mentioned essential measures. Medical training and the consequent development of the industry will then naturally take place, as it was the case for other professional groups in the past.
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Affiliation(s)
- Henrike Schulze
- Clinic of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Marisa Nacke
- Cancer Research UK, Beatson Institute, Glasgow, UK
| | - Christoph Gutenbrunner
- Clinic of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
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Mete Civelek G, Aypak C, Turedi O. Knowledge of Primary Care Physicians About Breast-Cancer-Related Lymphedema: Turkish Perspective. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:687-692. [PMID: 26159749 DOI: 10.1007/s13187-015-0880-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Breast-cancer-related lymphedema (BCRL) is a common complication of breast cancer treatment. Informing patients about BCRL can contribute to decrease their risk of developing the condition or prevent it from progressing further. In order to educate patients about BCRL effectively, clinical knowledge of clinicians must be adequate. In study, we aimed to reflect BCRL knowledge and attitude of Turkish primary care physicians (PCPs). This questionnaire-based study was conducted by face-to-face interview method. The participants included actively working PCPs from all parts of Turkey. The questionnaire elicited data on physicians' demographics, the BCRL knowledge, self-reported BCRL knowledge, referral patterns, and education. A total of 314 PCPs with a mean age of 36.9 % ± 8.1 years (mean ± standard deviation) were included in the study. Median BCRL knowledge score of all study group was 15 (11-18) [median (25-75 % range)]. PCPs who received education about BCRL during their medical faculty and/or residency periods had significantly higher knowledge scores (p = 0.005). Of PCPs, 94.9 % indicated to make a BCRL referral for a breast cancer patient. Among them, 55 % preferred to make a referral to a general surgeon, 28.2 % to an oncologist, and 16.8 % to a physical medicine and rehabilitation specialist. Assessment of factors related with BCRL should be part of routine evaluation of patients with breast cancer in primary care. Education of PCPs about BCRL is warranted in order to improve the BCRL care.
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Affiliation(s)
- Gul Mete Civelek
- Department of Physical Medicine and Rehabilitation, Dıskapı Yıldırım Beyazıt Education and Research Hospital, Irfan Bastug Caddesi, Dıskapı, Altındag, Ankara, 06110, Turkey.
| | - Cenk Aypak
- Department of Family Medicine, Dıskapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Ozlem Turedi
- Department of Family Medicine, Dıskapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
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Casillas JM. Improving scientific production in cardiovascular rehabilitation: A reasonable challenge for the Annals? Ann Phys Rehabil Med 2015; 58:117-8. [DOI: 10.1016/j.rehab.2015.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 04/17/2015] [Indexed: 11/29/2022]
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13
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Lu SR, Hong RB, Chou W, Hsiao PC. Role of physiotherapy and patient education in lymphedema control following breast cancer surgery. Ther Clin Risk Manag 2015; 11:319-27. [PMID: 25750536 PMCID: PMC4348127 DOI: 10.2147/tcrm.s77669] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION This retrospective cohort study evaluated whether education in combination with physiotherapy can reduce the risk of breast cancer-related lymphedema (BCRL). METHODS We analyzed 1,217 women diagnosed with unilateral breast cancer between January 2007 and December 2011 who underwent tumor resection and axillary lymph node dissection. The patients were divided into three groups: Group A (n=415), who received neither education nor physiotherapy postsurgery; Group B (n=672), who received an educational program on BCRL between Days 0 and 7 postsurgery; and Group C (n=130), who received an educational program on BCRL between Days 0 and 7 postsurgery, followed by a physiotherapy program. All patients were monitored until October 2013 to determine whether BCRL developed. BCRL risk factors were evaluated using Cox proportional hazards models. RESULTS During the follow-up, 188 patients (15.4%) developed lymphedema, including 77 (18.6%) in Group A, 101 (15.0%) in Group B, and 10 (7.7%) in Group C (P=0.010). The median period from surgery to lymphedema was 0.54 years (interquartile range =0.18-1.78). The independent risk factors for BCRL included positive axillary lymph node invasion, a higher (>20) number of dissected axillary lymph nodes, and having undergone radiation therapy, whereas receiving an educational program followed by physiotherapy was a protective factor against BCRL (hazard ratio =0.35, 95% confidence interval =0.18-0.67, P=0.002). CONCLUSION Patient education that begins within the first week postsurgery and is followed by physiotherapy is effective in reducing the risk of BCRL in women with breast cancer.
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Affiliation(s)
- Shiang-Ru Lu
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Rong-Bin Hong
- Departments of Physical Medicine and Rehabilitation, Chi-Mei Medical Center Liouying Campus, Tainan, Taiwan
| | - Willy Chou
- Department of Physical Medicine and Rehabilitation, Chi-Mei Medical Center, Tainan, Taiwan ; Department of Recreation and Health Care Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Pei-Chi Hsiao
- Department of Physical Medicine and Rehabilitation, Chi-Mei Medical Center, Tainan, Taiwan ; Department of Recreation and Health Care Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
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Rimaud D, Convert R, Calmels P. In vivo measurement of compression bandage interface pressures: The first study. Ann Phys Rehabil Med 2014; 57:394-408. [DOI: 10.1016/j.rehab.2014.06.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 06/04/2014] [Accepted: 06/04/2014] [Indexed: 10/25/2022]
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