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Osteopathic manual therapy as an adjunct treatment for the self-management of breast cancer related lymphoedema: A prospective case series

Journal: Unpublished MSc thesis Unitec Institute of Technology, Date: 2014/01, Pages: 206, type of study: case series

Free full text   (https://www.researchbank.ac.nz/handle/10652/6005)

Keywords:

breast cancer [14]
case series [40]
female [379]
lymphoedema [2]
OMT [2951]
osteopathic manipulative treatment [2973]
women [333]

Abstract:

BACKGROUND Current understanding of breast cancer related lymphoedema (BCRL) and associated management strategies tend to be based on poor research, anecdotal evidence and clinical opinion. This prospective case series explored the potential of osteopathic manual therapy (OMT) as a complementary management option, evaluated the capacity for inherent fluctuation in arm volume, and quantified the relationship between temperature, humidity and volume on other lymphoedema associated variables. METHODS Seven women with BCRL conducted regular assessment of arm volume, symptoms, function and quality of life over seven weeks. The volume measurements were conducted by the participants with a novel, validated tool; the ‘home arm volumeter’. The intervention phase included six OMT sessions, with additional measurements conducted pre and post treatment. The data were analysed separately for each individual using a range of methods and a range of thresholds were used to determine potentially meaningful results for the various outcomes. RESULTS Though the results showed diversity in the participant response to OMT, the instances of change in excess of the operational thresholds was generally clinically favourable. Arm volume fluctuated in both arms with greater change in the affected arm. There were isolated instances where climatic parameters were correlated with BCRL variables, and where volume changes were correlated with perception of symptoms and function. CONCLUSION The response to OMT highlighted the potential for OMT as an adjunct treatment. There appears to be inherent variability of arm volume in women living with BCRL, challenging basic assumptions on which BCRL research is conducted, such as the use of the unaffected arm as a control. The relationship between temperature, humidity and volume as driving factors of lymphoedema variables was not universal, and certain women may display a mismatch between volume and the subjective experience of BCRL. However, the exploratory nature of the study tempers these conclusions and further research is warranted


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