Effectiveness of Kinesio Taping on Anastomotic Regions in Patients with Breast Cancer-Related Lymphedema: A Randomized Controlled Pilot Study

Effectiveness of complete decongestive therapy for upper extremity breast cancer-related lymphedema: a review of systematic reviews

Breast cancer-related lymphedema (BCRL) remains a challenging condition impacting function and quality of life. Complete decongestive therapy (CDT) is the current standard of care, necessitating a comprehensive review of its impact. This paper presents a systematic review (SR) of SRs on CDT's efficacy in BCRL, and the components of manual lymph drainage (MLD) and exercise. A literature search yielded 13 SRs published between January 2018 and March 2023 meeting inclusion criteria, with varied quality ratings based on the AMSTAR II. A sub-analysis of CDT investigated the within group effect size estimations on volume in different stages of lymphedema. While a moderate quality SR indicated support for CDT in volume reduction, other SRs on the topic were of critically low quality. Larger effect sizes for CDT were found for later stage BCRL. The impact of MLD as a component of CDT demonstrated no additional volume benefit in a mix of moderate to low quality SRs. Similarly, exercise's role in volume reduction in CDT was limited, although it demonstrated some benefit in pain and quality of life. A rapid review of trials published January 2021-March 2023 reinforced these findings. Variability in CDT delivery and outcomes remained. These findings underscore the need to standardize staging criteria and outcome measures in research and practice. Future research should focus on refining interventions, determining clinically important differences in outcomes, and standardizing measures to improve evidence-based BCRL management. Current evidence supports CDT's efficacy in BCRL. MLD and exercise as components of CDT have limited support for volume reduction.

The effect of kinesiotaping on edema: A systematic review and meta-analysis

BACKGROUND

Treatment for edema involves multiple approaches, with Kinesiotaping having recently emerged as an option for edema reduction.

OBJECTIVE

To systematically summarize current evidence on the effects of Kinesiotaping on edema reduction on any type of edema.

METHODS

A systematic review was performed including randomized clinical trials that compared the effects of Kinesiotaping to any other intervention or no intervention on edema. Screening, assessment of methodological quality (PEDro scale) of studies, and confidence of evidence (GRADE) were analyzed by two independent reviewers. A quantitative summary is presented through meta-analyses.

RESULTS

A total of 3750 studies were identified, of which 70 were included in this review, and were organized by body region (face, upper limbs and lower limbs) and by treatment time (short and long term). It was observed that Kinesiotaping was superior to comparison groups in the short-term for face edema (Standardized mean difference [SMD] -1.07; 95%CI -1.48 to -0.65) and lower limbs (SMD -0.55; 95%CI -1.06 to -0.05). Also, Kinesiotaping was superior to comparison group in the long-term for lower limbs (SMD -0.72; 95%CI -1.25 to -0.18). Kinesiotaping was not superior to the comparison groups for upper limbs in both the short (SMD -0.05; 95%CI -0.89 to 0.80) and long-term (SMD -0.04; 95%CI -0.31 to 0.24) protocols.

CONCLUSION

Kinesiotaping seems to be an effective intervention to reduce acute edema around the face and potentially in the lower limbs in both short and long-term protocols, although the quality of evidence is very low. However, these positive results were not observed for the upper limbs.

Effect of Kinesiology Taping on Breast Cancer-Related Lymphedema: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

PURPOSE

The objective of this systematic review and meta-analysis was to evaluate the impact of kinesiology taping on individuals suffering from breast cancer-related lymphedema.

METHODS AND METHODS

We conducted a comprehensive search in PubMed, Cochrane Library, and Embase databases, spanning from their inception date to December 20, 2023, to identify pertinent studies. Inclusion criteria comprised studies that (1) enrolled participants diagnosed with breast cancer-related lymphedema; (2) implemented kinesiology taping as the intervention; (3) incorporated either complete decongestive therapy, exercise, or sham taping as the control treatment; and (4) included clinical measurements such as the severity of lymphedema, upper limb function assessment, quality of life, and perceived comfort.

RESULTS

Information was extracted from 14 randomized controlled trials (RCTs). The analyses demonstrated statistically significant improvement, indicating a preference for kinesiology taping in the outcomes of upper limb functional assessment (standardized mean difference [SMD] = -0.88, 95% confidence interval [CI]: [-1.22, -0.55]), quality of life (SMD = 0.50, 95% CI: [0.16, 0.84]), and perceived comfort (SMD = 0.85, 95% CI: [0.34, 1.36]).

CONCLUSION

The findings suggest that kinesiology taping could be considered a viable option for individuals dealing with breast cancer-related lymphedema. Nevertheless, acknowledging certain limitations within this study, further confirmation of its benefits necessitates additional larger-scale and better-designed RCTs.

The use of adhesive elastic tape for hand oedema control in patients with a wrist fracture treated in a cast: A pilot study

BACKGROUND

The adhesive elastic tape use is indicated for controlling oedema, although currently there is not the definitive evidence regarding its effectiveness. Wrist fractures are a frequent occurrence, often leading to oedema development in patients treated with forearm casts. This pilot study aims to investigate the effects of elastic tape in controlling hand oedema among patients with forearm casts for wrist fractures and the feasibility of a future randomized controlled trial.

METHODS

The study was conducted on adult patients with unilateral conservatively treated wrist fracture. The tape was applied to the intervention group after cast application, while the control group received the standard treatment. The circumference difference between baseline and the 7-day follow-up of both the 1st finger and the remaining 4 fingers merged together was evaluated. Ethical approval for the study has been obtained.

RESULTS

23 participants were enrolled. The intervention group showed a higher reduction in finger circumferences compared to the control group (median difference T1-T0 No tape vs Tape: 0 cm vs -0.2 cm for the 1st finger and 0.5 cm vs -0.5 cm for the remaining 4 fingers), although the changes were not statistically significant.

CONCLUSION

Although the number of enrolled patients was limited due to Covid-19 pandemic, the study results suggest a potential reduction in oedema after the use of adhesive elastic tape, justifying the needed of a future full-scale study. Given its low cost and ease of use, we believe that tape can be considered in clinical practice.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04683887.

Efficacy of kinesio taping on upper limb volume reduction in patients with breast cancer-related lymphedema: a systematic review of randomized controlled trials

INTRODUCTION

One of the most common disabling complications in breast cancer (BC) patients is breast cancer-related lymphedema (BCRL), a pathological condition affecting both physical and psychological function, with detrimental consequences on health-related quality of life (HR-QoL). Rehabilitation has a key role in the comprehensive management of this condition with several studies reporting positive results after performing complex decongestive therapies (CDT) in these women. Kinesio taping (KT) is a rather recent therapeutic approach to treat BCRL, however, evidence in literature regarding its effectiveness is far from being fully characterized. Therefore, this systematic review aimed at assessing the role of KT among the CDT to treat BCRL.

EVIDENCE ACQUISITION

PubMed, Scopus, and Web of Science were systematically searched from inception until May 5th, 2022 to determine randomized control trials (RCTs) reporting patients with BCRL; KT as intervention; limb volume as outcome (PROSPERO number: CRD42022349720).

EVIDENCE SYNTHESIS

Out of the documents identified, 123 were eligible for data screening, and only 7 RCTs satisfied the eligibility criteria and were included. We found that KT might have a positive effect on limb volume reduction in patients with BCRL, albeit there is little evidence for low quality of the included studies.

CONCLUSIONS

Taken together, this systematic review showed that KT did not significantly reduce the upper limb volume in BCRL women, albeit it seemed to increase the flow rate during the passive exercise. Further high-quality-studies are mandatory to improve the knowledge in order to include the KT might into a multidisciplinary rehabilitative approach for the management of BC survivors affected by lymphedema.

Safety and Feasibility of a Kinesiotape Application for Secondary Hand Lymphedema: A Case Series

Background: The safety and feasibility of using kinesiotape as a short-term alternative treatment to compression garments or gloves for hand lymphedema have not been examined. The aim of this study was to examine if kinesiotape could maintain size and extracellular fluid (ECF) volume of the hand and forearm, as well as upper limb function and quality of life for women with secondary hand lymphedema. Methods and Results: Six women with secondary hand lymphedema underwent pretreatment measurements, including hand and digit size using a tape measure; ECF volume using bioimpedance spectroscopy; and patient-reported outcome measurements of upper limb function and quality of life. Kinesiotape was then applied to the dorsum of the hand and left for 48 h, during which participants were asked not to wear compression garments. Posttreatment measurements were completed after kinesiotape removal. Changes in measurements were compared to the smallest detectable change (SDC). Hand size did not change more than the SDC; however, a single affected digit increased in circumference by more than the SDC. Changes of the whole arm ECF volume were less than the SDC. The ECF volume of the dorsum of the hand increased in one and decreased in another participant. The forearm ECF volume decreased in two participants. Upper limb function and quality of life did not change. No adverse event was reported. Conclusion: Short-term kinesiotape use appears to be safe in maintaining the physical presentation of hand lymphedema. However, these results should be examined in a larger sample. The feasibility of using kinesiotape as an alternative treatment to compression requires further investigation. Clinical Trial Registration number: ACTRN12618001232224p, July 23, 2018 retrospectively registered.

Clinical Experience with Compression Taping to Treat Seroma After Breast Cancer Surgery: A Medical Device Clinical Study

OBJECTIVE

To evaluate the safety of compressive taping in patients with seroma secondary to breast cancer surgery.

METHODS

This study was a nonrandomized clinical study of medical devices applied to women indicated for seroma aspiration puncture after breast cancer surgery in a public reference hospital in Brazil. The intervention consisted of applying compressive taping over the seroma fluctuation area and maintained for 5 days. Evaluated outcomes comprised dermal changes caused by taping, subjective symptoms reported during the intervention period, and percent change in the punctured volume before and after the intervention.

RESULTS

A total of 35 women (mean age, 56.7 ± 12.2 years) were included. Most presented with an advanced disease stage (≥IIB; 62.9%). Although a 28.6% incidence of dermal changes caused by taping was observed, an average reduction in the aspirated volume of -28.2 mL was identified (95% confidence interval, -48.3 to -8.0; P = .008). Treatment adherence was high (91.4%), and most patients reported satisfaction with the treatment (85.7%).

CONCLUSIONS

The use of compressive taping on seroma areas can be considered safe, is well accepted by patients, and might be used as a noninvasive treatment option for seroma developing after breast cancer surgery.

The efficacy of Kinesio taping on lymphedema following head and neck cancer therapy: a randomized, double blind, sham-controlled trial

OBJECTIVE

The aim was to investigate the effectiveness of Kinesio taping for lymphedema following head and neck cancer therapy and its effect on patient compliance and quality of life.

METHODS

A total of 66 patients with lymphedema following head and neck cancer therapy were randomly allocated to the therapeutic Kinesio taping group (n = 33) and the sham Kinesio taping group (n = 33). All participants received manual lymphatic drainage, Kinesio taping, and home exercises for the first four weeks, and only home exercises for the second four weeks. The tape measurements, a scale of external lymphedema, a scale of the internal lymphedema, and quality of life were evaluated in both groups. The perceived discomfort consisting of limitation of daily living activities, pain, tightness, stiffness, and heaviness were also recorded.

RESULTS

When the group x time effect was evaluated, it was observed that external lymphedema was significantly reduced in both groups according to neck and face composite measurements (p < .001). However, in these measurements, a significant difference was found between the groups in favor of the KT group (p = .001, p = .032, respectively). At the end of the study, there was no significant difference in terms of internal lymphedema in both groups (p = .860). The quality of life parameters such as global health status and swallowing were significantly better in the Kinesio taping group (p < .001). There was no significant difference in the parameters of perceived discomfort between the two groups (p = .282, p = .225, p = .090, p = .155, p = .183, respectively).

CONCLUSION

Kinesio taping is effective in tape measurements and positively affects the quality of life in lymphedema following head and neck cancer therapy.

Effects of Complex Physical Therapy and Multimodal Approaches on Lymphedema Secondary to Breast Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials

OBJECTIVE

What are the immediate, short-term, and long-term effects of complex physical therapy and multimodal approaches on lymphedema secondary to breast cancer?

DATA SOURCES

Four electronic databases (MEDLINE, Embase, Cochrane Library, Physiotherapy Evidence Database) were searched from inception up to August 2020.

STUDY SELECTION

Randomized controlled trials comparing complex physical therapy and multimodal approaches to the conservative treatment of lymphedema secondary to breast cancer.

DATA EXTRACTION

Two independent researchers performed data extraction and assessed the risk of bias, respectively, using the predefined form and Cochrane Collaboration of Risk of Bias. The determination of evidence quality was carried out using the Grading of Recommendations Assessment, Development, and Evaluation tools.

DATA SYNTHESIS

Fourteen studies were identified for the systematic review and 11 studies for the meta-analysis with standardized mean difference (SMD), 95% CI, and random-effect model. The common outcomes involved total volume, pain, and physical function of the upper limb. Complex physical therapy has shown a favorable tendency to control outcomes in the short- and long-term. The meta-analysis indicated a small effect for volume reduction (SMD, -0.18; 95% confidence interval [CI], -0.35 to 0.00) and a moderate effect for short-term pain reduction (SMD, -0.61; 95% CI, -1.19 to -0.02).

CONCLUSIONS

High-quality evidence suggests a more significant effect of complex physical therapy on multimodal approaches to the control of the upper limb total volume, substantiating the absence of changes in the current clinical practice in the management of lymphedema secondary to breast cancer. Future research should aim to identify concrete effect of therapeutic modalities in the immediate-, short-, and long-term.

Randomised controlled prospective study of the use of adhesive elastic tape for the control of hand oedema in patients with a wrist fracture treated in a cast: a study protocol

BACKGROUND

Wrist fractures are a common occurrence, affecting patients of all ages. Wrist fracture patients often develop oedema and the presence of a cast increases the risk. The use of adhesive elastic tape is indicated for oedema control, but there is no definitive evidence of its effectiveness. This study aims to evaluate the effectiveness of the tape in control of hand oedema in wrist fracture patients with a forearm cast.

METHODS

We present a study protocol for a randomised controlled trial with blinded data processing. We will apply the tape to the intervention group after cast application, while the control group will receive the standard treatment. We will evaluate the circumference difference between baseline (T0) and the 7-day follow-up (T1) of both the thumb and of the other 4 fingers merged together. We will collect data regarding re-attendance to the Orthopedic Emergency Room due to "intolerance to the plaster cast". Sample size calculations resulted in a required total of 220 participants (110 per group). Ethical approval for the study has been obtained.

DISCUSSION

We aim to demonstrate that the use of tape improves the tolerability of the cast by reducing the oedema formation, the feeling of constriction and pain.

TRIAL REGISTRATION

ClinicalTrial.gov Identifier: NCT04683887.

Features, Predictors, and Treatment of Breast Cancer-related Lymphedema

Purpose of review

Breast cancer-related lymphedema (BCRL) is a common sequelae among breast cancer survivors. This review provides updated information on recent studies to prevent, diagnose, and actively treat women with BCRL.

Recent findings

In total, 63 articles were identified from 2015 and 2020 that assessed incidence, risk factors, surveillance, measurement and definition, treatment, and awareness of BCRL. Depending on the approach and timing of assessment, BCRL incidence rates ranged from 9.1% to 39%. Modified radical mastectomy, number of positive lymph nodes, and postoperative complications were linked to BCRL risk, in addition to chemotherapy, radiation, axillary lymph node dissection, advanced cancer stage, and higher body mass index. Early detection showed favorable BCRL outcomes (e.g., severity, symptoms). Exercise, self-management, complete decongestive therapy, bandaging, and surgery had positive effects on BCRL outcomes.

Summary

Numerous gaps exist within BCRL literature, such as the value of self-reported surveillance options to identify BCRL early, measurement strategies, and definitions of BCRL. In terms of policies, efforts are needed to educate providers, patients, payers, and legislators about the need for consensus to reduce the burden of BCRL in women being treated for breast cancer.

Effects of Kinesio Taping and compression stockings on pain, edema, functional capacity and quality of life in patients with chronic venous disease: a randomized controlled trial

OBJECTIVE

The aim of this study was to compare the effects of Kinesio Taping and compression stockings on pain, edema, functional capacity and quality of life in patients with chronic venous disease (CVD).

DESIGN

This is a prospective, randomized, controlled, single-blind clinical trial.

SETTING

The study was conducted in a physiotherapy and rehabilitation unit of a university hospital.

SUBJECTS

A total of 62 patients with early-stage CVD were allocated to either an experimental group or a control group.

INTERVENTIONS

Experimental group (n = 29) received Kinesio Taping intervention once a week for four weeks, while control group (n = 29) received compression stockings for four weeks. All patients additionally undertook an exercise training programme including calf muscle pump exercises, flexibility exercises and diaphragmatic breathing.

MAIN MEASURES

Visual analogue scale, lower limb circumference measurements, 6-minute walk test and Short Form 36 questionnaire were applied before and after four weeks of treatment.

RESULTS

Control group showed statistically significant improvements in pain (P < 0.001), ankle circumferences (right, P = 0.002; left, P = 0.037), calf circumferences (right, P = 0.020; left, P = 0.022), knee circumference (left, P = 0.039) and thigh circumferences (right, P = 0.029; left, P = 0.002) compared with experimental group. There were no significant differences between groups with respect to functional capacity and quality of life (P > 0.05). Both groups significantly improved 6-minute walk distance (P < 0.001) and Short Form 36 physical component summary (experimental group, P = 0.002; control group, P = 0.006).

CONCLUSION

This study demonstrated that Kinesio Taping and compression stockings revealed similar improvements of functional capacity and quality of life in patients with CVD. The symptoms of pain and edema caused by CVD can be decreased more efficiently with compression stockings than Kinesio Taping intervention.