Early prevention of complex decongestive therapy and rehabilitation exercise for prevention of lower extremity lymphedema after operation of gynecologic cancer

Abstract

Objective: To investigate efficacy of early prevention of complex decongestive therapy and rehabilitation exercise for prevention of postoperative lower limb extremity lymphedema for patients with gynecologic cancer. Methods: 109 female patients were randomly divided into two groups, the control group who only received routine treatment and the CDT group who received both CDT and rehabilitation exercise. For rehabilitation exercise, patients received additional rehabilitation exercise strategy including professional education and full range exercise of hip joint. The incidence of lower extremity lymphedema was recorded. A simple scale for patients’ lower extremity lymphedema was designed. The diameter of low limbs (both thighs and calves) was also measured The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the Brief Fatigue Inventory (BFI) was used for measurement of quality of life. Results: The incidence of lower extremity lymphedema was 15.09% cases of CDT group and 32.14% in the control group. K-M curve showed the lymphedema free time in CDT group was significantly longer. The subjective scores for heaviness of lower limbs, pain, numbness and dysfunction, as well as the diameters of both thighs and calves were lower in the CDT group. In both groups, the values of EORTC QLQ-C30-GHS and EORTC QLQ-C30-FS were significantly higher, and EORTC QLQ-C30-SS scores and BFI scores were remarkably lower. Conclusion: Early prevention of CDT combined with rehabilitation exercise reduced incidence of lower limb extremity lymphedema and improved patients’ quality of life, as well as reduced the cancer-related fatigue.

Keywords

• Complex decongestive therapy
• Rehabilitation exercise
• Lower extremity lymphedema
• Gynecological cancer