Effect of early interventions with manual lymphatic drainage and rehabilitation exercise on morbidity and lymphedema in patients with oral cavity cancer

Kuo-Yang Tsai; Su-Fen Liao; Kuan-Lin Chen; Hao-Wei Tang; Hsin-Ya Huang

doi:10.1097/MD.0000000000030910

Effect of early interventions with manual lymphatic drainage and rehabilitation exercise on morbidity and lymphedema in patients with oral cavity cancer

Medicine (Baltimore). 2022 Oct 21;101(42):e30910. doi: 10.1097/MD.0000000000030910.

Authors

Kuo-Yang Tsai¹, Su-Fen Liao^{2

3

4}, Kuan-Lin Chen⁵, Hao-Wei Tang⁶, Hsin-Ya Huang⁷

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Show Chwan Memorial Hospital, Changhua, Taiwan.
² Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua, Taiwan.
³ Division of Pediatric Rehabilitation, Changhua Christian Children's Hospital, Changhua, Taiwan.
⁴ Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
⁵ Department of Physical Medicine and Rehabilitation, Yuan Rung Medical Corporation Yuan Sheng Hospital, Yuanlin city, Changhua County, Taiwan.
⁶ Department of Physical Medicine and Rehabilitation, Yumin Medical Corporation Yumin Hospital, Caotun Town, Nantou County, Taiwan.
⁷ Branch of Physical therapy, Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua, Taiwan.

Abstract

Background: There are clinical and statistical inconsistencies regarding early intervention with manual lymphatic drainage (MLD). The purpose of this study was to compare the short-term effect of early interventions with rehabilitation exercise versus MLD and rehabilitation exercise in terms of pain, range of motion (ROM) and lymphedema in patients with oral cancer after surgery.

Methods: A total of 39 patients who underwent surgery from December 2014 to December 2018 participated in this randomized single-blind study. There were 20 patients in the rehabilitation (R) group and 19 in the MLD (M) plus rehabilitation group. The R group received 30 minutes of rehabilitation intervention; and the M group received 30 minutes of MLD, in addition to 30 minutes of rehabilitation intervention in a work day. Clinical measures, including the visual analog pain scale (VAS), ROM of the neck and shoulder, ultrasonography and face distance for lymphedema, and the Földi and Miller lymphedema scales, were assessed before surgery, before intervention and when discharged from the hospital.

Results: The VAS pain score, ROM of the neck, and internal and external rotation of the right shoulder were significantly improved after the interventions. Right-face distance (P = .005), and skin-to-bone distance (SBD) of the bilateral horizontal mandible and left ascending mandibular ramus were significantly improved after the interventions. Left lateral flexion of the neck (P = .038) and SBD of the right ascending mandibular ramus (P < .001) in the MLD group showed more improvement than that of the rehabilitation group.

Conclusion: Early intervention with MLD and the rehabilitation program were effective in improving ROM of the neck and controlling lymphedema in acute-phase rehabilitation. The preliminary findings suggest a potential therapeutic role for early intervention with MLD, in addition to rehabilitation exercise, in that they yielded more benefits in lymphedema control and improvement of ROM of the neck in acute care.

Publication types

Randomized Controlled Trial

MeSH terms

Breast Neoplasms*
Exercise Therapy
Female
Humans
Lymphedema* / etiology
Manual Lymphatic Drainage
Morbidity
Mouth Neoplasms* / complications
Mouth Neoplasms* / surgery
Pain
Range of Motion, Articular
Single-Blind Method