Physical Therapist Leads First-of-its-Kind Research Study
ALEXANDRIA, VA, May 21, 2008 — A recent study shows that
pre-operative assessments of patients with breast cancer by physical
therapists allow for early diagnosis and successful treatment of
lymphedema.
The study, conducted by the National Naval Medical Center (NNMC) and
the National Institutes of Health (NIH) and in collaboration with the
University of Michigan-Flint and George Mason University, was published
in the journal, Cancer (April 25, 2008). The authors demonstrated the
effectiveness of a surveillance program that included pre-operative limb
volume measurement and interval post-operative follow-up to successfully
detect and treat lymphedema, a chronic and often irreversible condition
that can cause significant swelling of the upper and lower extremities
due to the build-up of excess lymph fluid.
"This study is significant for several reasons, but none more so than
it showing that detection and management of lymphedema at early stages
may prevent the condition from progressing to a chronic, disabling stage
and may enable a more cost-effective, conservative intervention," said
American Physical Therapy Association (APTA) spokesperson and the
study's lead author, Nicole L Stout Gergich, PT, MPT, CLT-LANA, of the
National Naval Medical Center (NNMC) Breast Care Center, in Bethesda,
Maryland.
Breast cancer related lymphedema is associated with decreased arm
function, disability and diminished quality of life. If the condition is
not diagnosed early and managed, it can progress to a situation where
the patient is at risk for infection and further shoulder complications.
The swelling is disfiguring and many times prohibits patients from
finding clothes that fit properly.
Stout noted that the baseline pre-operative assessment of 196
patients with breast cancer participating in the study - which was
conducted from 2001 to 2005 - included basic strength, range of motion,
limb volume, and physical activity level. "To measure limb volume, we
employed infra-red technology that scans the limbs using beams and
sensors, providing us with very accurate information," she said. All
study participants were monitored one month post-surgery and at
three-month intervals thereafter for one year even if they exhibited no
swelling. "Using both the pre- and post-operative assessments enabled us
to diagnose lymphedema before it became visible, which is an
unprecedented accomplishment," Stout noted.
Once lymphedema was diagnosed in 43 of the patients participating in
the study, the condition was managed using a conservative compression
garment, atypical of lymphedema treatment, observed Stout. A light-grade
compression sleeve and gauntlet, fitted by the physical therapist, were
prescribed for daily wear. "Lymphedema is normally treated with more
aggressive and often costly and time-consuming techniques, such as
complete decongestive therapy, which requires the patient to attend
daily therapy sessions for weeks and wear bulky compression bandages.
This study clearly demonstrates that the condition can be managed with a
more conservative treatment option when it is diagnosed at its earliest
presentation, which will be good news to breast cancer patients," she
added.
"What we hope to garner from publicizing this study is that it will
encourage patients with breast cancer to ask the questions that need to
be asked regarding their treatment, as well as galvanize physicians,
surgeons, oncologists and other physical therapists to make early
intervention and conservative treatment of lymphedema the standard of
care in breast cancer care," Stout concluded.
Physical therapists are health care professionals who diagnose and
manage individuals of all ages, from newborns to elders, who have
medical problems or other health-related conditions that limit their
abilities to move and perform functional activities in their daily
lives. Physical therapists examine each individual and develop a plan of
care using treatment techniques to promote the ability to move, reduce
pain, restore function, and prevent disability. Physical therapists also
work with individuals to prevent the loss of mobility by developing
fitness- and wellness-oriented programs for healthier and more active
lifestyles.
The American Physical Therapy Association (www.apta.org) is a
national organization representing physical therapists, physical
therapist assistants, and students nationwide. Its goal is to foster
advancements in physical therapist education, practice, and research.
Consumers can visit www.findapt.us to find a physical therapist in their
area, as well as www.moveforwardpt.com for physical therapy news and
information.