림프부종의 물리치료적 접근과 관리 : 전문가 견해 = Physical Therapy Approach and Management for Lymphedema : Expert Opinion

다국어 초록 (Multilingual Abstract)

Background : Lymphedema is a progressive disorder characterized by the impairment of lymph flow from tissues to the blood circulation system. This occurs as a result of damage to the lymphatic system. Complex decongestive therapy (CDT) is a multimodal, conservative therapeutic approach that is used for the management of lymphedema. CDT consists of a combination of compression therapy, manual lymphatic drainage, exercise, and skin care.
Purpose : This study aimed to provide a review of available physical therapy interventions as well as general care guidelines for patients with lymphedema.
Methods : The recommendations and guidelines for physical therapy management, medical management, and general information were reviewed from the following sources: (1) The American Physical Therapy Association, (2) The Norton School of Lymphatic Therapy, and (3) The International Society of Lymphology. This review contains general information, including the medical management and the importance of physical therapy in lymphedema. Physical therapy management should be based on an assessment of the patients’ presenting impairments, including based on inclusion or exclusion of physical therapy interventions. This review also outlines a step-by-step approach that starts with disease diagnosis and progression all the way through to rehabilitation as an outpatient.
Conclusion : Depending on the patients’ journey to recovery and the requirement for rehabilitation, physical therapy interventions should focus on the patients’ needs including pain, appearance, physical function and general rehabilitation. We hope that this review will provide information on evidence-based physical therapy and general care to patients with lymphedema.

참고문헌 (Reference)

1 서종현 ; 조창노 ; 김성천 ; 정승현 ; 고은실 ; 김광기, "피부의 탄성변화에 따른 피부 가압과 복귀시간 측정을 통한정량적 림프부종 진단 시스템 개발" 대한의용생체공학회 34 (34): 170-176, 2013

2 하경진 ; 최승준, "유방절제술로 발생된 상지 림프부종 환자의 치료적 운동 고찰" 한국운동생리학회 25 (25): 69-75, 2016

3 박찬란 ; 이가영 ; 손창규 ; 조정효 ; 이남헌, "유방암 환자의 림프부종에 대한 한의학적 치료: 체계적 문헌 고찰" 대한한방내과학회 40 (40): 343-355, 2019

4 양규환 ; 심재용, "림프부종의 진단과 치료" 대한의사협회 56 (56): 1115-1122, 2013

5 최윤선, "림프부종" 한국호스피스완화의료학회 3 (3): 118-125, 2000

6 이원희 ; 김광기 ; 정승현, "깊이 영상의 평면 검출 기반 3차원 정합 기법을 이용한 상지 부종의 부피 측정 기술" 한국멀티미디어학회 17 (17): 818-828, 2014

7 Foeldi E, "peripheral lymphedema" Springer 189-194, 2021

8 Kim DI, "congenital vascular malformations" Springer 297-305, 2017

9 Tyker A, "Treatment for lymphedema following head and neck cancer therapy : a systematic review" 40 (40): 761-769, 2019

10 Kasseroller RG, "The vodder school: the vodder method" 83 (83): 2840-2842, 1998

11 Sanal-Toprak C, "The efficacy of intermittent pneumatic compression as a substitute for manual lymphatic drainage in complete decongestive therapy in the treatment of breast cancer related lymphedema" 52 (52): 82-91, 2019

12 Executive Committee of the International Society of Lymphology, "The diagnosis and treatment of peripheral lymphedema: 2020 consensus document of the international society of lymphology" 53 : 3-19, 2020

13 Coriddi M, "Systematic review of patient-reported outcomes following surgical treatment of lymphedema" 12 (12): 2020

14 Godoy MDFG, "Synergic effect of compression therapy and controlled active exercises using a facilitating device in the treatment of arm lymphedema" 9 (9): 280-284, 2012

15 Schaverien MV, "Surgical treatment of lymphedema" 144 (144): 738-758, 2019

16 Fish ML, "Quality-of-Life Outcomes in surgical vs nonsurgical treatment of breast cancer–related lymphedema : a systematic review" 155 (155): 513-519, 2020

17 Chung SH, "Psychiatric management of lymphedema" 5 (5): 17-26, 2020

18 Abe K, "Postural differences in the immediate effects of active exercise with compression therapy on lower limb lymphedema" 29 (29): 6535-6543, 2021

19 Health insurance review & assessmentservice, "Physiotherapy cost"

20 Tzani I, "Physiotherapeutic rehabilitation of lymphedema : State-of-the-art" 51 (51): 1-12, 2018

21 Sun F, "Perometry versus simulated circumferential tape measurement for the detection of breast cancer-related lymphedema" 172 (172): 83-91, 2018

22 Ridner SH, "Pathophysiology of lymphedema" 29 (29): 4-11, 2013

23 Fujiyoshi T, "Pathological changes in the lymphatic system of patients with secondary lower limb lymphedema based on single photon-emission computed tomography/computed tomography/lymphoscintigraphy images" 20 (20): 144-152, 2022

24 Thompson B, "Manual lymphatic drainage treatment for lymphedema : a systematic review of the literature" 15 (15): 244-258, 2021

25 Thompson B, "Manual lymphatic drainage treatment for lymphedema : A systematic review of the literature" 15 (15): 244-258, 2021

26 Mehrara BJ, "Lymphedema and obesity : is there a link?" 134 (134): 154-160, 2014

27 Blausen.com, "Lymphatic system female"

28 Vaahtomeri K, "Lymphangiogenesis guidance by paracrine and pericellular factors" 31 (31): 1615-1634, 2017

29 Schingale FJ, "Investigation of the less known effects of manual lymphatic drainage : a narrative review" 20 (20): 7-10, 2022

30 Davies C, "Interventions for breast cancer–related lymphedema : clinical practice guideline from the academy of oncologic physical therapy of APTA" 100 (100): 1163-1179, 2020

31 Tran K, "Intermittent pneumatic compression devices for the management of lymphedema: a review of clinical effectiveness and guidelines"

32 Saffar HA, "How can adjustable velcro wraps help in the management of lymphedema in the absence of complex physical therapy facilities" 2021

33 Baumann FT, "Effects of physical exercise on breast cancer-related secondary lymphedema : a systematic review" 170 (170): 1-13, 2018

34 Rangon F, "Effects of complex physical therapy and multimodal approaches on lymphedema secondary to breast cancer: a systematic review and meta-analysis of randomized controlled trials" 103 (103): 353-363, 2021

35 Se Hyun Oh ; Sung Hwan Ryu ; Ho Joong Jeong ; Jung Hyun Lee ; Young-Joo Sim, "Effects of Different Bandaging Methods for Treating Patients With Breast Cancer-Related Lymphedema" 대한재활의학회 43 (43): 677-685, 2019

36 Tesar E, "Effect of common medications on breast cancer-related lymphedema" 36 (36): 7-12, 2018

37 Kim KG, "Development of lymphedema measurement system using 3d volumetry" 20 (20): 38-44, 2014

38 Mosti G, "Compression therapy in lymphedema : Between past and recent scientific data" 34 (34): 515-522, 2019

39 Scaglioni MF, "Comprehensive review of vascularized lymph node transfers for lymphedema : outcomes and complications" 38 (38): 222-229, 2018

40 Duyur Cakıt B, "Complex decongestive therapy in breast cancer-related lymphedema : does obesity affect the outcome negatively?" 17 (17): 45-50, 2019

41 Borman P, "Complex decongestive therapy and resistance exercises in the treatment of lymphedema associated with breast cancer and the effect of pain on treatment response" 22 (22): e270-e277, 2022

42 Jeffs E, "Clinical effectiveness of decongestive treatments on excess arm volume and patient-centered outcomes in women with early breast cancer-related arm lymphedema : a systematic review" 16 (16): 453-506, 2017

43 Chaput G, "Cancer-related lymphedema : clinical pearls for providers" 27 (27): 336-340, 2020

44 Brix B, "Biology of Lymphedema" 10 (10): 2021

45 Center for Medicare and Medicaid Services, "Billing and coding: Lymphedema decongestive treatment"

46 Suami H, "Anatomy of the lymphatic system and the lymphosome concept with reference to lymphedema" 32 (32): 5-11, 2018

47 Walker J, "A systematic review of pharmacologic and cell-based therapies for treatment of lymphedema(2010-2021)" 10 (10): 966-975, 2021

48 Smile TD, "A review of treatment for breast cancer-related lymphedema" 41 (41): 178-190, 2018