Treatment of upper limb lymphedema with low-level laser: a systematic review

Abstract

Introduction Low-level lasers have been suggested as a complement to lymphedema treatment. However, this therapy’s mechanism of action and its effects are poorly understood up to the present. Objective To conduct a systematic literature review to analyze the effects of low-level laser in the treatment of upper-limb lymphedema in women submitted to breast cancer surgery. Material and methods Randomized clinical trials were included, in Portuguese, English and Spanish, from January 1990 to July 2013. The article search was carried out in the Pubmed, Lilacs and PEDro electronic databases, with the following descriptors:Terapia a Laser de Baixa Intensidade, Linfedema, Câncer de Mama, Low-level laser therapy, Lymphedema, Breast Neoplasms and also through a manual search. Results and discussion Low-level lasers have been used for treating several acute and chronic conditions. However, its application for managing post breast cancer surgery is still recent, often based on empirical evidence. Treating upper-limb lymphedema with low-level laser presented positive results, with reduction in the circumference or volume of the affected limb. Conclusion More studies of high methodological quality are needed in order to better understand the mechanism of action of low-level laser on the lymphatic system and its effects on lymphedema treatement.

The effectiveness and safety of low-level laser therapy on breast cancer–related lymphedema: An overview and update of systematic reviews

“…The characteristics of seven reviews included in this overview were presented in Table 1 . All reviews were published in English between 2007 and 2019 and undertaken in six different areas including China [ 25 ], New Zealand [ 26 ], America [ 27 ], Brazil [ 28 , 29 ], Egypt [ 30 ], and Britain [ 31 ], respectively. Two reviews employed meta-analysis methods as data synthesis, yet the remaining five that did not use it were narrative systematic reviews.…”

“…The number of primary trials for LLLT included in each review ranged from 3 to 11, and the sample sizes ranged from 71 to 359. Three reviews [ 25 , 28 , 29 ] included only RCTs, and four [ 26 , 27 , 30 , 31 ] included both RCTs and observational studies.…”

“…2. According to the evaluation criteria, two (28.6%) [25,26] reviews were of low quality and five (71.4%) [27][28][29][30][31] of critically low quality. All the reviews explicitly described the components of PICO, used comprehensive search strategies, conducted the study selection and data extraction in duplicate, and describe the included studies in adequate detail.…”

“…The intervention groups were mostly LLLT and conventional therapy in the treatment group, and the control groups were mostly conventional therapy (compression therapy, manual lymphatic drainage, limb exercise), placebo laser therapy, and no treatment. The methodological quality assessment scales varied across the included reviews: five used the Physiotherapy Evidence Database (PEDro) scale [26][27][28][29][30][31], and one adopted the Risk of Bias (RoB) 2.0 scale [25], and one used both the PEDro scale and Newcastle-Ottawa Scale (NOS) [31]. The primary studies overlap of included reviews was reported in Table 2.…”

Which physical therapy intervention is most effective in reducing secondary lymphoedema associated with breast cancer? Protocol for a systematic review and network meta-analysis

“…Physical therapy treatment (PTT)12 focused on BCRL includes a wide range of interventions, such as complete decongestive therapy, manual lymphatic drainage, low-level laser therapy, shock waves, pneumatic pumps, Kinesio-taping, and endurance training/aerobic exercise, multimodal training, water training, yoga and Pilates. Currently, there are several systematic reviews that evaluate the efficacy of these different PTTs in reducing BCRL 13–47…”