Complex Decongestive Physiotherapy Associated Compression Therapy in the Treatment of Secondary Lymphedema in Breast Cancer: a Systematic Review

Abstract

Introduction: Breast cancer is the most frequent cancer in the female population, and the lymphedema of the upper limb the most frequent complication in mastectomy. Object: To perform a systematic review and assess the effectiveness of complex decongestive physical therapy associated with the use of kinesiotape, compressive bandaging and pneumatic compression in the treatment of secondary lymphedema in breast cancer. Method: A systematic review the following databases was performed: MEDLINE, PEDro, Cochrane CENTRAL, EMBASE, Portal Periódicos Capes, CINAHL and Google Scholar. The keywords were: "kinesiotape", "bandage", "drainage", "mastectomy", "lymphedema", "physioterapy", "physical therapy", "compressive bandaging", "pneumatic compression". Results: We selected ten randomized controlled trials. It was verified in studies that pneumatic compression reduces the volume of lymphedema when associated with complex decongestive physiotherapy. The compressive bandaging proved to be effective in reducing lymphedema, but is often abandoned by patients during treatment due to discomfort.  he kinesiotape is an alternative therapy for patients who aren’t adapted to the bandaging. However, studies that prove its effectiveness are mostly case studies and, for that reason, are not sufficient to confirm its clinical applicability. Conclusion: This systematic review has proved to be important in the sense that it allowed us to analyze the effects of each technique. However, randomized clinical trials are still scarce on this topic, especially on the use of kinesiotape, making it difficult to establish which technique is more effective in reducing lymphedema and maintenance of reduction levels achieved during complex decongestive physiotherapy.