A Cochrane review [Abstract] 1 included three randomised controlled clinical trials on the physical treatments for lymphoedema, with a total of 150 subjects. Each studied a different intervention.
One crossover study of manual lymph drainage (MLD) followed by self-administered massage versus no treatment, concluded that improvements seen in both groups were attributable to the use of compression sleeves and that MLD provided no extra benefit at any point during the trial. Another trial looked at hosiery versus no treatment and had a very high dropout rate, with only 3 out of 14 participants in the intervention group finishing the trial and only 1 out of 11 in the control group. The authors concluded that wearing a compression sleeve is beneficial. The bandage plus hosiery versus hosiery alone trial concluded that in this mixed group of participants bandage plus hosiery resulted in a greater reduction in excess limb volume than hosiery alone and this difference in reduction was maintained long-term.
Comment: The quality of evidence is downgraded by limitations in study quality, by inconsistency (heterogeneity in interventions and outcomes) and by imprecise results (limited study size for each comparison).
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