As part of the research, the FS1 Group in collaboration with the Lymphedema, Lipedema, Chronic Venous Insufficiency, and other Vascular Diseases Association of Galicia (Spain), are analyzing the benefits of maintaining Manual Lymphatic Drainage (MLD) treatment in women with breast cancer and studies the benefits of long-term treatment in patients who have had a mastectomy.
The nearly 40 participating members are part of the Physiotherapy Program that the AGL Association has been developing since 2015 with the collaboration of the Xunta de Galicia (Government of Galicia), the ONCE Foundation, the Provincial Council of A Coruña, and the Provincial Council of Pontevedra.
The study is being carried out in coordination with physiotherapists with training at specialist level who are part of the AGL Association Physiotherapy Program: Castro y Cea Physiotherapy (Santiago de Compostela); Javier Agenjo Physiotherapy Center (El Ferrol); Physiocentrum (Ourense) and O Castro Physiotherapy Center (Vigo).
This research provides the opportunity to demonstrate the importance of Manual Lymphatic Drainage (MLD) as an essential part of the treatment of this disease.
"Manual Lymphatic Drainage (MLD) is applied in the early stages of lymphedema, and what we want to show is that it should also be done in the lifelong Maintenance Phase", says Dean of Physiotherapy and principal investigator of the study Dr. Eva Mª Lantarón, with researchers from the Vigo University School Dr. Mercedes Soto, Dr. Rocío Abalo and Dr. Iria Da Cuña. As part of its collaboration with the AGL Association, the study seeks to "demonstrate the benefits" of maintenance treatment received by its association members, which in recent weeks has led researchers from the Pontevedra Campus to carry out the first of a series of evaluations to about 40 women participating in the study. All of them, explains Dr. Lantarón, are patients who have been affected by breast cancer, who have suffered lymphedema after a mastectomy and who after initial Manual Lymphatic Drainage (MLD), have continued to receive treatment by the physiotherapists with training at specialist level who collaborate with the association.
CONFIRMING THE BENEFITS FOR PATIENTS
What is known as "Complex Decongestant Therapy" (CDT), which includes Manual lymphatic Drainage (MLD) together with a series of therapeutic exercises, compression devices, and skincare is the usual treatment of lymphedema in the “Initial Phase”, having demonstrated its effectiveness as indicates Dr. Lantarón, by achieving "a clear reduction in the edema of the subcutaneous tissue." She explains that after achieving this improvement there is a second phase, on which the study is focused, aimed to preserve and optimize the results obtained and ensure that the edema does not reappear. In this sense, the objective of this research is to verify the effectiveness of this maintenance phase, since although some studies have focused on its benefits, "there are also certain trends that indicate that it is not necessary".
MEASUREMENTS IN THREE PROVINCES OF GALICIA (SPAIN)
The nearly 40 members participating in the study are part of the Physiotherapy Program that the AGL Lymphedema Association has been developing since 2015 with the collaboration of the Xunta de Galicia (Government of Galicia), the ONCE Foundation, the Provincial Council of A Coruña, and the Provincial Council of Pontevedra, which allows them to carry out maintenance treatments throughout the year.
This "cross-sectional, randomized and blind clinical trial" lead the researchers of the FS1 Group to carry out measurements in the Galician cities of Vigo, Ourense, Santiago de Compostela, and Ferrol, in coordination with physiotherapists with training at specialist level who are part of the AGL Physiotherapy program: Castro and Cea Fisioterapia (Santiago de Compostela); Javier Agenjo Physiotherapy Center (Ferrol); Physiocentrum (Ourense) and O Castro Physiotherapy Center (Vigo).
The participants are divided into two homogeneous groups says Dr. Lantarón, one of which undergoes a "more intensive Manual Lymphatic Drainage (MLD) treatment" undertaken by the association's physiotherapists during a month, while the second group does not receive any treatment during this period. Before and after, the researchers carry out an evaluation of the participants, without knowing at any time whether they belong to one or the other group. After a two-month "washout period", in which they return to the pre-trial treatment, the group with whom lymphatic drainage had not been performed in the first phase proceeds to carry out the intensive treatment, with a weekly session, while that the other becomes the "control group" and do not receive any treatment.
Before and after each of the phases, the diameter of the affected upper limb is measured at different anatomical points, the level of swelling of the arm, due to the "displacement of the fluid volume", and the thickness of the subcutaneous tissue by ultrasound, as well as an evaluation of the muscular strength of the patients. All these measurements it is explained, are performed on both the affected and non-affected arm.
"It will also depend on whether the patient suffers from it in the dominant limb or not, but lymphedema implies limitations in daily life, so in the end, these are treatments that can improve their quality of life," says Dr. Lantarón, who points out that one of the purposes for carrying out this study, without external funding, "is because it is necessary to reverse our work to society." At the same time, the Dean emphasizes, that the collaboration with the AGL Association goes back many years and contributes to "educate physiotherapy students of the role they play regarding patients with lymphedema."
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