Low level laser therapy in the management of postmastectomy lymphoedema

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Low level laser therapy in the management of postmastectomy lymphoedema

 

Author: Lau, Wing-lum Rufina
Title: Low level laser therapy in the management of postmastectomy lymphoedema
Degree: M.Sc.
Year: 2006
Subject: Hong Kong Polytechnic University -- Dissertations
Breast -- Cancer -- Patients -- Rehabilitation
Lasers -- Therapeutic use
Department: Dept. of Rehabilitation Sciences
Pages: x, 84 leaves : col. ill. ; 30 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b1986352
URI: http://theses.lib.polyu.edu.hk/handle/200/5427
Abstract: Breast cancer is one of the most common forms of cancer among women in Hong Kong. Postmastectomy lymphoedema (PML) is a common complication of breast cancer interventions such as operations and radiotherapy. The development of PML for breast cancer survivors is distressing as patients with PML often experience certain discomfort symptoms or even functional impairment. The significance of PML in psychosocial morbidity should not be overlooked. Moreover, conventional physiotherapy therapy is usually labour-intensive and time-consuming. Investigators are, therefore, in search of a more economical but yet effective intervention for the management of PML. The use of low level laser therapy (LLLT) for PML was first reported by Piller and Thelander in 1995. Their results found that LLLT is effective in reducing arm volume, extracellular fluid and tissue hardness. However, their study did not include a control group. This study was designed to examine the treatment effect of low lever laser therapy (LLLT), as compared to a control group, for the management of PML. The present study was single-blinded randomised controlled clinical trial. Twenty-one Chinese females with a mean age of 51.1 ± 8.5 years old suffered from PML were recruited, and randomly assigned into two groups. The laser group (n=11) received a cycle of LLLT 3 times a week for 4 weeks and the control group received no laser irradiation. A follow-up was scheduled in the 8th week.
The outcome measures were assessed prior to treatment on Week 1, Week 4 and the Follow-up. Arm volume and the tissue resistance were monitored by tank volumetry and tonometry respectively. The subjective symptoms were assessed by the Chinese version of the Disabilities of Arm, Shoulder and Hand (DASH-HKPWH) questionnaire. General linear model repeated measures analysis of variance (ANOVA) was used for the data analysis. After 4 weeks of LLLT, there was no significant improvement immediately after the treatment period. However, there were significant between-group differences for arm volume and tissue resistance at the anterior torso and forearm upon the Follow-up session. Arm volume had a cumulative reduction by 16% in the laser group after LLLT and it reached 28% by the Follow-up. The tonometry readings over the forearm and anterior torso had cumulative increase from 15% to 33% indicating significant softening of the tissue in the affected arm but the tissue resistance in the upper arm only showed a slight improvement. The laser group showed a progressive trend of improvement in subjective symptoms of the affected arm. The results in the present study suggested that LLLT reduced volume and improved the tissue resistance of the affected arm for patients with PML. Subjective parameters also showed a trend of improvement after laser treatment. The therapeutic effects of the twelve sessions of LLLT could improve both the objective and subjective parameters upon the Follow-up.

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