Researchers from the UVigo Faculty of Physiotherapy and the AGL association are carrying out a study on lymphedema

In the framework of this research, the FS1 group in collaboration with the Galician Association of Lymphedema, Lipedema, Chronic Venous Insufficiency and other peripheral vascular pathologies (AGL), is analyzing the benefits of maintaining lymphatic drainage treatment in women with breast cancer, and study the benefits of long-term treatment in mastectomized patients.

The nearly 40 participating members are part of the Physiotherapy Program that AGL has been developing since 2015 with the collaboration of the Xunta de Galicia (through the contribution of 0.7% of personal income tax), the Priority Plan of the ONCE Foundation, the Deputation of A Coruña and Deputation of Pontevedra.

This study is being carried out in coordination with the professionals who are part of the Physiotherapy Program of the AGL association: Castro y Cea Fisioterapia in Santiago de Compostela; Javier Agenjo Physiotherapy Center in Ferrol; Fisiocentrum in Ourense and the O Castro Physiotherapy Center in Vigo.

This research provides an opportunity to demonstrate the importance of manual lymphatic drainage as an essential part in the treatment of this disease.

One of the problems arising from performing a mastectomy on women affected by breast cancer is the appearance of lymphedema, swelling of the arm affected by the extraction of lymph nodes, which leads to a decrease in mobility, pain, heaviness or lack of sensitivity in the affected member. Faced with this pathology, the performance of a manual lymphatic drainage by physiotherapists has been shown to be an effective treatment in reducing the accumulation of lymph that causes this swelling and the problems that arise from it. To verify the effectiveness of maintaining this treatment over time, in a maintenance phase of lymphedema, is the aim of the study that researchers from the FS1 group of the Faculty of Physiotherapy develop in these months in collaboration with the Galician Association of Lymphedema, Lipedema, Chronic Venous Insufficiency and other pathologies peripheral vascular (AGL).

"Lymphatic drainage is applied in early stages and what we want to show is that it must also be done in a lifelong maintenance phase," says Eva Mª Lantarón, dean of Physiotherapy and principal investigator of this study with researchers from the faculty Mercedes Soto , Rocío Abalo and Iria Da Cuña. As part of their collaboration with this association, the study seeks to "demonstrate the benefits" of this maintenance treatment received by its members, which in recent weeks has led researchers from the Pontevedra campus to perform the first of a series of evaluations at about 40 women participating in the study. All of them, explains Lantarón, are patients who have been affected by breast cancer, who have suffered from lymphedema after mastectomy and who, after the initial lymphatic drainage, have continued to receive treatment from the physiotherapists who collaborate with the association.

Confirm the benefits they perceive

The so-called "complex decongestant therapy", which involves performing lymphatic drainage along with a series of therapeutic exercises, compression techniques and skin care, is the usual treatment for lymphedema in a first phase, having shown its effectiveness, as Lantarón points out, when achieving "a clear reduction in edema of the subcutaneous tissue." After achieving this improvement, a second phase, in which the study focuses, would aim to preserve and optimize the results obtained and ensure that the edema does not reappear. In this sense, the aim of this research is to verify the effectiveness of this maintenance phase, since although some studies have affected its benefits, "there are also certain currents that indicate that it is not necessary," he explains.

Measurements in three provinces

The nearly 40 members participating in the study are part of the Physiotherapy Program that AGL has been developing since 2015 with the collaboration of the Xunta de Galicia (through the contribution of 0.7% of personal income tax), the Priority Plan of the ONCE Foundation , the Provincial Council of A Coruña and the Provincial Council of Pontevedra, and which makes it possible for them to carry out maintenance treatment throughout the year.

This "cross-sectional, randomized and blinded clinical trial" leads FS1 group researchers to perform measurements in Vigo, Ourense, Santiago de Compostela and Ferrol, in coordination with professionals who are part of the AGL Physiotherapy program: Castro y Cea Fisioterapia en Santiago of Compostela; Javier Agenjo Physiotherapy Center in Ferrol; Fisiocentrum in Ourense and the O Castro Physiotherapy Center in Vigo.

Participants are divided into two homogeneous groups, one of which undergoes over a month a "more intensive treatment of manual lymphatic drainage" by the physiotherapists of the association, while the second does not receive any treatment in this period. Before and after, the researchers carry out an evaluation of the participants, without knowing at any time if they belong to one or another group, in such a way that "we are not suggested in any way," says Lantarón. After a “washing period” of two months, in which they return to the pre-trial treatment, the group with which the lymphatic drainage had not been carried out in the first phase proceeds to perform this intensive treatment, with a weekly session, while the other it becomes the “control group” and does not receive any treatment.

Before and after each of the phases, measurements are made of the diameter of the affected upper limb at different anatomical points, the level of swelling of the arm, through the "displacement of water volume", and the thickness of the subcutaneous tissue by ultrasound, as well. as well as an assessment of patients ’muscle strength. All these measurements, they explain, are made on both the affected arm and the other.

"It will also depend on whether you suffer from it in your dominant hand or not, but lymphedema is limited in daily life, so in the end these are treatments that can improve your quality of life," says Lantarón, who points out that one of the purposes for those who carry out this study, without external funding, "is because it is necessary to reverse our work in society." At the same time, the dean emphasizes that the collaboration with this association comes from many years ago and contributes "to make students aware of the role they can play with patients with lymphedema."

Contact details AGL: Galician Association of Lymphedema, Lipedema, Chronic Venous Insufficiency and other peripheral vascular pathologies (AGL). Phone 986 505 443 / 630 024 428
 E-mail: info@linfedemagalicia.com 
 Contact person: Juan Manuel Lameiro Barreiro (president) / María Araujo Rey (social worker)
 www.linfedemagalicia.com