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Manual lymphatic drainage compared with simple lymphatic drainage in the treatment of post-mastectomy lymphoedema: a pilot randomised trial [with consumer summary]
Sitzia J, Sobrido L, Harlow W
Physiotherapy 2002 Feb;88(2):99-107
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

PURPOSE: To determine whether manual lymphatic drainage (MLD) is significantly more effective than simple lymphatic drainage (SLD) in reducing oedematous limb volume in women with breast cancer related arm oedema. DESIGN: Randomised trial. METHODS: The study measured change in affected limb volume over a two-week intensive treatment period. One group of patients (n = 13) was treated with SLD, the other group (n = 15) with MLD. All patients were treated daily by the same lymphoedema specialist nurse and wore multi-layered bandaging between treatments. The sole outcome measure was percentage change in excess limb volume (PCEV) following treatment. RESULTS: The mean percentage reduction in PCEV was 33.8% in the MLD group and 22.0% in the SLD group (mean difference 1 1.8%, 95%CI -3.8% to +27.4%). CONCLUSIONS: These data suggest that MLD is more effective than SLD in reducing limb swelling. However, the data are not statistically conclusive. These results firmly support the need for this study to be replicated with a larger, statistically viable sample.

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