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Available from: Malcolm Granat
Available from: Yolande Borthwick
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ABSTRACT: Breast cancer-related lymphoedema (BCRL) affects 24-42% of patients following treatment for breast cancer. The gold standard method of measuring hand swelling associated with BCRL is to use water displacement (volumeter). This is not always possible in the clinical setting and the figure-of-eight method, which involves wrapping a simple measuring tape around the hand in a specific way, may be an alternative. The aim of the study was to examine the reliability and validity of the figure-of-eight method of measuring hand size in women with BCRL. Twenty-four patients with hand swelling associated with BCRL participated. Two novice testers performed three 'blinded' figure-of-eight measurements and three volumetric measurements of each hand. In terms of intertester (between-tester) and intratester (within-tester) reliability, the intraclass correlation coefficients were all greater than 0.8 indicating high intra- and intertester reliability for the figure-of-eight method. For validity, a Pearson's moment correlation computed between the figure-of-eight and volumetric methods highlighted a statistically significant correlation of 0.7 between the methods for both testers. The figure-of-eight method was found to be a valid and reliable method of measuring hand swelling in this population.
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ABSTRACT: In the acute phase of lymphoedema, patients require comprehensive decongestive therapy (CDT), which includes skin care, an exercise regimen, manual lymphatic drainage (MLD) and regular bandaging. This study was established to determine the effectiveness of a new system of bandage therapy, the 3M™ Coban™ 2 compression system. In total, 24 patients were entered into the study (12 from UK and 12 from Canada) with a variety of clinical presentations. The mean age of the groups was 57·4 years, which varied from 26 to 79 years. Body mass index (BMI) averaged 38·9 kg/m(2) , with a range from 22·7 to 67·5 kg/m(2) . Of the total, eight were women with arm lymphoedema, the remainder being men and women with lymphoedema of the lower limb. All were considered to be in need of CDT. After 19 days, the reduction of limb volume was measured, which indicated a mean limb volume reduction of 1210 ml (95% confidence interval, CI, 780-1641, P < 0·001). Leg affected patients experienced greater reduction than arm affected patients (1596 ml versus 438 ml), although both groups experienced significant reduction in limb volumes (both P < 0·001). Mean percentage changes in limb volume were 14·9% and 16·1% for legs and arms, respectively. The Measure Your Medical Outcome Profile questionnaire indicated significant improvement in symptoms considered important by the patient (P < 0·0001), which also led to improvements in skin quality by reducing skin thickness and firmness. The Coban 2 compression system provides good oedema reduction in both arms and legs to reduce limb volume and improvements in symptoms associated with lymphoedema.
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