Effect of Kinesio® Taping on Lower Limb Lymphedema Secondary to Gynecological Cancer
Marysa Meyer
PT 640
Research Question: What is the effect of applying Kinesio© Tape to the lower extremity of patients with lymphedema secondary to gynecological cancer treatments?
Abstract:
Background and Purpose. Lower limb lymphedema (LLL) is a common outcome of gynecological cancer treatment. LLL in gynecological cancer survivors can lead to a decreased quality of life while interfering with the ability to participate in daily activities. The current gold standard for treatment for lymphedema of the lower extremity is complete decongestive therapy (CDT), however concerns regarding adherence and long term effects are posed in current research on this
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The primary outcome measure will be circumferential measurements of the lower extremity and secondary outcome measures will be quality of life and adherence. These measures will be taken one month before start of the study, post 4-weeks of treatment, and at a two month follow up. This research could provide evidence for the use of KT as an alternative treatment within CDT, or to enhance current CDT outcomes.
Specific Aims:
1. To determine if Kinesio® Taping on the lower extremity affects limb circumference in patients with lower limb lymphedema secondary to gynecological cancer.
2. Determine if Kinesio® Taping on the lower extremity affects quality of life of gynecological cancer patients.
3. Determine if Kinesio® Taping on the lower extremity affects adherence to complete decongestive therapy treatment in gynecological cancer patients.
Background and Significance: Lower limb lymphedema (LLL) induced by standard surgical and radiation treatment for gynecological cancers is a serious complication that can lead to adverse physical and mental patient outcomes1. It is estimated that between 7 and 78 percent of patients treated for gynecological cancers develop LLL after beginning their medical treatment regimen2,3,4. This substantial disparity is likely due to variable definitions of lymphedema, bias regarding how lymphedema is
A review of her medical records indicates that she did have her bladder biopsy which confirmed bladder cancer. She is starting radiation therapy today with Dr. Cook. Her radiation treatments will be 5 days a week for 5 weeks. She reports that her chronic HTN is stable with medication; her opiate induced constipation is stable. She states that her bowel regimen is on hold due to her having diarrhea. She continues to take Eloquis for DVT in left leg. She is followed by Dr. Rosen for oncologist.
First, all patients or their caregivers are expected to wash and roll the compression bandages after each use. Second, lymphedema patients are required to use a compression pump and compression garments after discharge from lymphedema clinic because lymphedema is a chronic condition and life-long management of the symptoms is imperative. The lymphedema self-management phase may incorporate the use of the assistive equipment, such as reaches (to apply the compression pump’s sleeves on the lower extremities) or compression stockings donning devices. In addition, many lymphedema patients are educated in self-bandaging, therapeutic exercises, and self-manual lymph drainage techniques and are expected to continue with these activities as a part of their daily
In addition, regression analysis was used to determine independent variable among age, BMI, grip strength, sex and K/L grade for knee pain. The result indicated that the most significant variable was BMI correlated with the occurrence of knee pain. ORs of BMI (+5 kg/m2) was 1.54 and the risk was 0.60 which was significant. This implied that the ORs of K/L grade for knee pain can be overestimated due to the possibility of extremely low risk of K/L grade. In fact, the percentage of participants who suffered from knee pain with K/L (grade 2) and K/L (grade 3 and 4) was just 61.0% and 71.0% respectively. In other words, it will be about 40% of participants with K/L grade 2 and about a third of subjects with K/L grade 3 and 4 had no pain at the knee joint at follow-up.
Pelvic floor muscle (PFM) exercises both with and without biofeedback have been shown to be a safe and effective way of significantly improving symptoms of UI. Randomised controlled trials and a Cochrane systematic review have shown that PFM exercises are an
Women who experience lymphedema after breast and lymph node removal often experience many physical and psychological struggles, that no one will quite understand unless you are the one living with the condition. More women are being diagnosed with breast cancer, or finding out they are carriers of the gene for breast cancer than ever before. Technology has allowed for earlier detection and better treatment options, with increasing survivor rates. As the survival numbers increase and more women are living with the aftermath of breast cancer treatment. Initial cancer treatment is not always life long, but the side effects to treatment can be. Women who experience lymphedema will likely experience a variety of emotional, physical, and psychological changes, some of theses changes are not able to be put in perspective until one researches it or experiences it for themselves.
Pain is one of the most common and feared complications of cancer. It is exacerbated by stress, anxiety, fatigue, and malaise which accompany advanced cancer. Pain is generally absent in the early stages of cancer, but it is a significant factor as the illness progresses to advanced stages. Cancer-associated pain can arise from a variety of direct and indirect mechanisms including direct pressure, obstruction, and invasion of a sensitive structure, stretching of visceral surfaces, tissue destruction, infection, and inflammation (McCance 2010). Pain is generally accepted as whatever the patient says it is, wherever the patient says it is. Treatment of pain and its associated symptoms is a primary responsibility of the healthcare team. Treatment modalities for pain include the use of opioid analgesics, patient-controlled analgesia, psychological interventions, and preventing recurrence of pain. Reinforcing the reporting of pain by the patient is important, as is a respect for the social and cultural differences with respect to pain perception.
Education sessions provided by trained staff Qld Cancer Foundation, stomal therapist, physiotherapist specialising in lymphoedema, past and
While these are high probabilities of treating the cancer, the quality of life afterward is still questionable. For instance, unintentional maleficence exists from the chemotherapy. A study by John Radford claims that “survivors of Hodgkin’s lymphoma are at substantial risk for one or more second cancers”. While chemotherapy is effective at treating lymphoma, it also seems to lead to a higher risk for a second cancer, and that cancer may need more chemotherapy. By Cassandra being forced to undergo treatment for her lymphoma she is also, inadvertently, getting this higher risk for more cancer later in her life. Moreover, Cassandra also faces the unwanted side effects of chemotherapy:“hair loss, mouth sores, loss of appetite, nausea and vomiting, diarrhea, increased chance of infections, easy bruising or bleeding, fatigue”. Not only is the chemotherapy not wanted, but it also comes with steep side effects that she must live with; the consequences of the involuntary treatment outweigh the chance that a person may survive - it is more important to respect a patient’s autonomy than to pursue a minimal, unwanted, questionable beneficence. A recent study reported on by Zosia Chustecka found that even eight years after the chemotherapy, “high-level fatigue was common”. Post chemotherapy there are changes that impact the quality of life of the
Identification of pain has been the most feared and common symptom of cancer (Sloan, et al. 1999). The joint project that includes primary, secondary and tertiary levels of care were successful in breaking down the barriers that crossed traditional boundaries in cancer care. Steering committee member were identified and meetings took place between multi-professional teams and project coordinators to identify their issues and concerns and communication, discharge, pain management and symptom control were identified. Multidisciplinary groups worked were
The initial diagnosis was made by her oncologist who was monitoring any changes over a six-month period after surgery and throughout radiation via physical examinations. Increased swelling became visibly obvious as did decreased range of motion and restricted normal functioning of the right arm. An occupational therapist and lymphedema specialist determined a follow up diagnosis after implementing a test using an electric current, which measures fluid volume in the arm and right trunk. (Physical Therapy and Rehab Medicine 2010) Also, comparisons in range of motion were made to the normal side on the left. Once the actual assessment of the problem was made, a plan was
As a podiatrist this form of biomechanical treatment to help strengthen muscles in the lower limb is what I would be recommending patient. Specialising in high risk patient management is a career path is would like to take as reducing the risk of amputation these patients may face due to their underlying illnesses, such as diabetes or cerebral palsy, would make a significant difference in their lives . After acquiring as much experience and gaining the relevant knowledge and expertise possible in this field I hope to set up my own
Pain, which is defined in its widest sense as an emotion which is the opposite of pleasure (White, 2004, p.455), is one of the major symptoms of cancer, affecting a majority of sufferers at some point during their condition (De Conno & Caraceni, 1996, p.8). The World Health Organization (WHO, 2009, online) suggests that relief from pain may be achieved in more than 90 percent of patients;
In the first couple of days of rehab, she received high volt, and ice to help with the swelling she also did ankle pumps that also help with moving out the inflammation. As each day went by, towel scrunches, towel stretches were performed as three set each. Compression pumps were administered for 15 minutes several times a week, rhythmic stabilization, and aquatic therapeutic exercises were added as she
Seven patients with surgically fixed pelvic fractures were randomly allocated into two groups at six weeks post fracture. The treatment group completed six weeks of daily NMES. The placebo group completed six weeks of daily transcutaneous electrical nerve stimulation (TENS). The percentage peak torque in the operated limb was measured at 12 weeks using a HUMAC strength assessment machine using the non-operated limb as a baseline.
To prevent frozen shoulder.This innovation will be an important tool in clinical nursing practice. Created and developed from reliable and modern evidence based practice. Include: 1) Care plan for patients undergoing breast surgery, 2) Daily recording form of arm and shoulder exercise,