【論文摘要】Therapeutic Effect of Low-level Laser on Swelling, Pain, and Grip Strength of Lymphedema after Mastectomy: A Meta-Analysis

【論文摘要】低能量雷射對乳房切除術後淋巴水腫的腫脹、疼痛和握力之療效－統合分析

余俊姿(June-Tzu Yu) ； 陳治中(Chih-Chung Chen) ； 蔡佳玲(Jia-Ling Tsai) ； 連心瑜(Angela Shing-Yu Lien)

《物理治療》 45卷2期 (2020/06) Pp. 132-133

https://doi.org/10.6215/FJPT.202006.O16

摘要

Background and Purpose: Breast cancer related lymphedema (BCRL) is an ordinary complication for those who has received the mastectomy surgery, which has many impacts on women's lives. The fluid accumulating in the upper extremity causing discomfort, pain and limited mobility in the patients' daily living. Low level laser treatment (LLLT) has been reported its effectiveness on BCRL on the change of limb circumference but little explored on analgesia and strength improvement relevant to motor aspect which physical therapist emphasized. Therefore, a meta-analysis following systematic literature search was conducted to compare their outcome benefits. Methods: Literatures were searched from PubMed, using the key words including ＂low level laser, low density laser or low power laser＂ and ＂lymphedema＂). Inclusion criteria was the randomized-controlled study reported by full-text English and published by December 2019. Exclusion criteria was animal study. Results: A total of five articles were retrieved. Two of them were deleted due to the data not comparable and 3 articles were retained for unified analysis. The results showed that swelling reduction of upper limb at circumference in means and standard error was -2.7 ± 2.2 cm (95% confidence interval [CI]: -7.2 to 1.8). Pain reduction was -0.26 ± 0.35 cm on visual analogue scale (VAS, 95% CI: -0.95 to 0.43). Grip strength was increased 2.20 ± 1.92 kg (95% CI: -1.56 to 6.00). No statistical significance was found at the three outcome measures. Among individual studies, the therapeutic benefit was observed larger between LLLT group and passive control group, such as placebo, than active control group, such as pneumatic compression therapy. Conclusion: This study showed that LLLT have a tendency in reducing the swelling circumference of the upper limb, recuing the pain, and restoring the grip strength although the statistical significance was not found in the meta-analysis. The heterogonous data due to study designs led to a statistical insignificance. Further well-designed studies with large scale are required to determine more exactly how effective LLLT. Clinical Relevance: LLLT did not change limb circumference, pain, and grip strength on BCRL although the therapeutic benefits was observed among the studies.