- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03250364
Compression Bandages in Upper Limb Lymphedema (CB-ULL)
June 2, 2020 updated by: Maria Torres Lacomba, University of Alcala
Compression Bandages in Upper Limb Lymphedema After Breast Cancer
Despite different types of bandages are using in the lymphedema treatment, numerous of them have not been directly compared.
The aim of this study is to compare the efficacy of five different kinds of bandages on limb volume and lymphedema-related symptoms.
It was also measured as secondary variables the comfort of the bandage related by the participants and the directly cost of each kind of bandage during the treatment.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
100
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Madrid
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Alcalà de Henares, Madrid, Spain, 28871
- Physiotherapy in women´s health research group. University of Alcalà
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Alcalá de Henares, Madrid, Spain, 28805
- University of Alcalá. FPSM research group. HUPA
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
20 years to 70 years (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
Female
Description
Inclusion Criteria:
- Women after breast cancer surgery undergoing upper limb lymphedema not previously treated
- Having more than two centimeters between two adjacent measurements between the lymphedematous and the contralateral upper limb
- The presence of heaviness, tension or fovea in the affected limb
- More than six months post-surgery or radiation to eliminate the possibility of being a post-chirurgical oedema
Exclusion criteria will be:
- Bilateral breast cancer surgery
- Only hand lymphedema
- Active cutaneous infection
- A loco-regional cancer recurrence
- The impossibility of complete all the physical therapy sessions
- A primary lymphedema
- Women with lymphedema symptoms like thickness and heaviness in the upper limb but without a difference of two centimeters in two adjacent points
- Any contraindication to physiotherapy
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: DOUBLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Multilayer bandage group
Manual lymphatic drainage (MLD) + upper limb (UL) exercises + educational strategy + multilayer bandage consisting of three layers.
The first was a 100% cotton tubular bandage which will be directly placed on the skin to prevent any injury ("Tubinylex TM").
The second layer is a paddle with the purpose of unify and increase pressure (Emulsified Latex FoamTM 8mm, Thuasne, France); and the third layer of inelastic bandages (6, 8 and/or 10 cm Rosidal K Short Stretch Bandage, Germany).
All the bandage layers will be placed from caudal to cranial in a circular disposition, overlapping in one third the previous layer for a correctly cover of the limb and not to leave open spaces.
The cotton tubular bandage and the short-stretch bandage could be cleaned without losing their material properties.
|
See arm/group descriptions
MLD using a modification of the strokes described by Leduc will be applied to lymphedema "resorption".
It will be included resorption maneuver in the oedematous areas of the affected limb, in cranial to caudal direction, since the physiotherapist seeing a change in the tissue qualities of the oedema.
Then, the subjects will be received thirty minutes of Intermittent Pneumatic Compression ("EureducTM") with a pression of 40 mmHg.
After the bandage will be put, proprioceptive neuromuscular facilitation exercises without resistance in two diagonal in asymmetrical reciprocal patterns with the affected limb will be taught.
The first diagonal into flexion from hitch hike to swat fly, and into extension from swat fly to hitch hike, and the second diagonal from hand in opposite pocket to carry tray, and into extension from carry tray to hand in opposite pocket.
These exercises must be done at home two times per day, ten repetitions each exercise.
Instructions about lymphatic system anatomy and pato-physiology, the prevention and identification of possible lymphedema complication or infection, how to use and exercise this arm, avoidance of trauma, injury, an excess of heat and arm constriction.
|
EXPERIMENTAL: Simplified multilayer bandage group
Manual lymphatic drainage (MLD) + upper limb (UL) exercises + educational strategy + double compression bandage consisting of two layers, made up of a first rigid cotton bandage (11 cm Bande coton Short Stretch; Thuasne, France) and a second elastic bandage ("BiflexTM" 16 light; Thuasne, France).
The two layers will be placed caudal to cranial in a circular manner, overlapping in one third the previous layer.
The elastic bandage have squares drawn to help to the physiotherapist to control the stretch they given to the bandage.
The two bandages could be cleaning without losing their properties.
If there was any oedema concentration or a fibrous place, a paddle pad will be put in these places ("Mobiderm TM", Thuasne, France).
|
MLD using a modification of the strokes described by Leduc will be applied to lymphedema "resorption".
It will be included resorption maneuver in the oedematous areas of the affected limb, in cranial to caudal direction, since the physiotherapist seeing a change in the tissue qualities of the oedema.
Then, the subjects will be received thirty minutes of Intermittent Pneumatic Compression ("EureducTM") with a pression of 40 mmHg.
After the bandage will be put, proprioceptive neuromuscular facilitation exercises without resistance in two diagonal in asymmetrical reciprocal patterns with the affected limb will be taught.
The first diagonal into flexion from hitch hike to swat fly, and into extension from swat fly to hitch hike, and the second diagonal from hand in opposite pocket to carry tray, and into extension from carry tray to hand in opposite pocket.
These exercises must be done at home two times per day, ten repetitions each exercise.
Instructions about lymphatic system anatomy and pato-physiology, the prevention and identification of possible lymphedema complication or infection, how to use and exercise this arm, avoidance of trauma, injury, an excess of heat and arm constriction.
See arm/group descriptions
|
EXPERIMENTAL: Cohesive bandage group
Manual lymphatic drainage (MLD) + upper limb (UL) exercises + educational strategy + cohesive bandage consisting of a single short-stretched layer that will be put directly on the subject skin and stick on itself (10cm 3M CobanTM Minnesota Mining and Manufacturing Co, United States).
It will be placed in a circular manner distal to cranial with a paddle pad in the elbow fold not to damage this moving part.
This bandage will be reused twice in the same subject.
|
MLD using a modification of the strokes described by Leduc will be applied to lymphedema "resorption".
It will be included resorption maneuver in the oedematous areas of the affected limb, in cranial to caudal direction, since the physiotherapist seeing a change in the tissue qualities of the oedema.
Then, the subjects will be received thirty minutes of Intermittent Pneumatic Compression ("EureducTM") with a pression of 40 mmHg.
After the bandage will be put, proprioceptive neuromuscular facilitation exercises without resistance in two diagonal in asymmetrical reciprocal patterns with the affected limb will be taught.
The first diagonal into flexion from hitch hike to swat fly, and into extension from swat fly to hitch hike, and the second diagonal from hand in opposite pocket to carry tray, and into extension from carry tray to hand in opposite pocket.
These exercises must be done at home two times per day, ten repetitions each exercise.
Instructions about lymphatic system anatomy and pato-physiology, the prevention and identification of possible lymphedema complication or infection, how to use and exercise this arm, avoidance of trauma, injury, an excess of heat and arm constriction.
See arm/group descriptions
|
EXPERIMENTAL: Adhesive compression bandage group
Manual lymphatic drainage (MLD) + upper limb (UL) exercises + educational strategy + adhesive compression bandage consisting of an elastic bandage ("BiplastTM" Thuasne, France.
Measures: 10cm x 2,5 m) which will put over a pre-tape bandage not to damage the skin.
It will be placed in a circular disposition from distal to cranial.
In each physiotherapy session, the bandage has to be replaced with a new one.
|
MLD using a modification of the strokes described by Leduc will be applied to lymphedema "resorption".
It will be included resorption maneuver in the oedematous areas of the affected limb, in cranial to caudal direction, since the physiotherapist seeing a change in the tissue qualities of the oedema.
Then, the subjects will be received thirty minutes of Intermittent Pneumatic Compression ("EureducTM") with a pression of 40 mmHg.
After the bandage will be put, proprioceptive neuromuscular facilitation exercises without resistance in two diagonal in asymmetrical reciprocal patterns with the affected limb will be taught.
The first diagonal into flexion from hitch hike to swat fly, and into extension from swat fly to hitch hike, and the second diagonal from hand in opposite pocket to carry tray, and into extension from carry tray to hand in opposite pocket.
These exercises must be done at home two times per day, ten repetitions each exercise.
Instructions about lymphatic system anatomy and pato-physiology, the prevention and identification of possible lymphedema complication or infection, how to use and exercise this arm, avoidance of trauma, injury, an excess of heat and arm constriction.
See arm/group descriptions
|
EXPERIMENTAL: Kinesiotaping bandage group
Manual lymphatic drainage (MLD) + upper limb (UL) exercises + educational strategy + kinesiotaping bandage consisting of K-Active" Tape.
The k-tape will be pasted directly on the skin and put longitudinally in thin bands in a cranio-caudal disposition.
The width of the bandage will be of 5cm, and will be cut in four bands that will cover all the upper limb cranial to caudal in a spiral way surrounded it.
The bandage will be placed moving the limb into internal and external rotation for putting the skin in a little stretch without lengthen the tape.
|
MLD using a modification of the strokes described by Leduc will be applied to lymphedema "resorption".
It will be included resorption maneuver in the oedematous areas of the affected limb, in cranial to caudal direction, since the physiotherapist seeing a change in the tissue qualities of the oedema.
Then, the subjects will be received thirty minutes of Intermittent Pneumatic Compression ("EureducTM") with a pression of 40 mmHg.
After the bandage will be put, proprioceptive neuromuscular facilitation exercises without resistance in two diagonal in asymmetrical reciprocal patterns with the affected limb will be taught.
The first diagonal into flexion from hitch hike to swat fly, and into extension from swat fly to hitch hike, and the second diagonal from hand in opposite pocket to carry tray, and into extension from carry tray to hand in opposite pocket.
These exercises must be done at home two times per day, ten repetitions each exercise.
Instructions about lymphatic system anatomy and pato-physiology, the prevention and identification of possible lymphedema complication or infection, how to use and exercise this arm, avoidance of trauma, injury, an excess of heat and arm constriction.
See arm/group descriptions
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in arm volume
Time Frame: 3 assessments to evaluate changes: at baseline (before intervention), after intervention (1 month from baseline) and 6 months after intervention
|
To assess the volume of the limb it will be used the circumference measurement.
The assessment will be with the subject in upright position with the arm placed on a table, the forearm relaxed on the table, the shoulder in a neutral rotation, a flexion of 45º of the elbow, and forearms in supine position.
The reference will be the elbow fold where was measure the circumference of the limb in 5cm intervals.
The circumference measurements will be converted into volume values with the truncated cone formula in each 5 centimeters long.
|
3 assessments to evaluate changes: at baseline (before intervention), after intervention (1 month from baseline) and 6 months after intervention
|
Change in heath related quality of life lymphedema
Time Frame: 3 assessments to evaluate changes: at baseline (before intervention), after intervention (1 month from baseline) and 6 months after intervention
|
It will be assessed by Lymphedema specific PRO instrument: Upper Limb Lymphedema (ULL)27 spanish validated version
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3 assessments to evaluate changes: at baseline (before intervention), after intervention (1 month from baseline) and 6 months after intervention
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in comfort of the bandage
Time Frame: 3 assessments to evaluate changes: at baseline (before intervention), after intervention (1 month from baseline) and 6 months after intervention
|
Numeric scale ranging from 0-10: 0 comfortable - 10: very uncomfortable
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3 assessments to evaluate changes: at baseline (before intervention), after intervention (1 month from baseline) and 6 months after intervention
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (ACTUAL)
August 10, 2014
Primary Completion (ACTUAL)
September 1, 2019
Study Completion (ACTUAL)
January 10, 2020
Study Registration Dates
First Submitted
August 4, 2017
First Submitted That Met QC Criteria
August 10, 2017
First Posted (ACTUAL)
August 15, 2017
Study Record Updates
Last Update Posted (ACTUAL)
June 4, 2020
Last Update Submitted That Met QC Criteria
June 2, 2020
Last Verified
June 1, 2020
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 18/2010
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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