Key findings on the role of complex decongestive therapy in lymphedema
| ARTICLE | LEVEL OF EVIDENCE* | GENERAL CONCLUSION |
|---|---|---|
| Godette et al,46 2006 | 5 | CDT cannot promote metastasis |
| Pinell et al,47 2008 | 5 | CDT can improve lymphedema in the presence of local or regional disease |
| Hamner and Fleming,44 2007 | 5 | CDT can reduce lymphatic volume and pain |
| Koul et al,42 2007 | 5 | CDT and MLD with exercise are associated with substantial reduction in lymphedema |
| Didem et al,48 2005 | 2 | CPP can improve shoulder mobility and lymphedema |
| Karadibak et al,45 2008 | 5 | CDT can decrease edema and fear of activity, and improve QOL |
| Kim et al,43 2007 | 5 | CDT improved QOL in maintenance phase |
| Johnstone et al,49 2006 | 5 | Reduced compliance with CDT in maintenance phase resulted in long-term lymphedema |
| Vignes et al,50 2007 | 5 | Noncompliance with maintenance phase resulted in increased lymphedema |
| Thomas et al,51 2007 | 5 | Radiation therapy did not reduce the effects of CDT |
| Yamamoto et al,52 2008 | 5 | Most edema reduction during CDT occurred during the first days, suggesting shorter treatment periods than indicated in current practice |
CDT—complex decongestive therapy, MLD—manual lymphatic drainage, CPP—complex physiotherapy program, QOL—quality of life.
↵* Levels of evidence range from 1, the strongest evidence (systematic reviews of randomized controlled trials), to 5, the weakest evidence (expert opinion).