• Oncology nursing forum · Jul 2013

    Randomized Controlled Trial

    A pilot randomized trial evaluating low-level laser therapy as an alternative treatment to manual lymphatic drainage for breast cancer-related lymphedema.

    • Sheila H Ridner, Ellen Poage-Hooper, Collin Kanar, Jennifer K Doersam, Stewart M Bond, and Mary S Dietrich.
    • School of Nursing, Vanderbilt University, Nashville, TN, USA. sheila.ridner@vanderbilt.edu
    • Oncol Nurs Forum. 2013 Jul 1; 40 (4): 383-93.

    Purpose/ObjectivesTo examine the impact of advanced practice nurse (APN)-administered low-level laser therapy (LLLT) as both a stand-alone and complementary treatment for arm volume, symptoms, and quality of life (QOL) in women with breast cancer-related lymphedema.DesignA three-group, pilot, randomized clinical trial.SettingA private rehabilitation practice in the southeastern United States.Sample46 breast cancer survivors with treatment-related lymphedema.MethodsPatients were screened for eligibility and then randomized to either manual lymphatic drainage (MLD) for 40 minutes, LLLT for 20 minutes, or 20 minutes of MLD followed by 20 minutes of LLLT. Compression bandaging was applied after each treatment. Data were collected pretreatment, daily, weekly, and at the end of treatment.Main Research VariablesIndependent variables consisted of three types of APN-administered lymphedema treatment. Outcome variables included limb volume, extracellular fluid, psychological and physical symptoms, and QOL.FindingsNo statistically significant between-group differences were found in volume reduction; however, all groups had clinically and statistically significant reduction in volume. No group differences were noted in psychological and physical symptoms or QOL; however, treatment-related improvements were noted in symptom burden within all groups. Skin improvement was noted in each group that received LLLT.ConclusionsLLLT with bandaging may offer a time-saving therapeutic option to conventional MLD. Alternatively, compression bandaging alone could account for the demonstrated volume reduction.Implications For NursingAPNs can effectively treat lymphedema. APNs in private healthcare practices can serve as valuable research collaborators.Knowledge TranslationLasers may provide effective, less burdensome treatment for lymphedema. APNs with lymphedema certification can effectively treat this patient population with the use of LLLT. In addition, bioelectrical impedance and tape measurements can be used to assess lymphedema.

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