Agreement between telerehabilitation involving caregivers and face-to-face clinical assessment of lymphedema in breast cancer survivors

Abstract

Lymphedema is a lifetime complication of breast cancer survivors that can limit their participation in recreational or strenuous daily activities. Follow-up of lymphedema using an Internet application could help patients to determine the influence on their condition of these activities and adapt them accordingly. We aimed to determine the level of agreement between lymphedema assessment by telerehabilitation and by the traditional face-to-face method. Thirty breast cancer survivors participated in a descriptive study of repeated measures using a crossover design. Patients attended a session for clinical face-to-face and real-time online telerehabilitation assessments of lymphedema. There was a 120-min interval between these two sessions. The order of sessions was randomly selected for each patient. A caregiver (relative or friend) conducted the telerehabilitation assessment using a system that includes a specific tool based on an arm diagram for measuring the participant's arm circumferences via a telehealth application. All outcome measures showed reliability estimates (α) ≥ 0.90; the lowest reliability was obtained for the total volume on the non-affected side (α = 0.90). The diagnosis of lymphedema by the two methods also showed good inter-rater reliability (Rho = 0.89). These preliminary findings support the use of an Internet-based system to assess lymphedema in breast cancer survivors, offering carers a useful role in helping patients to follow up this lifetime health problem.

Telehealth system: A randomized controlled trial evaluating the impact of an internet‐based exercise intervention on quality of life, pain, muscle strength, and fatigue in breast cancer survivors

“…Technological advancements may help to resolve barriers, such as distance, time, and cost . Taking into account the negative impact of disease on the quality of life of BC survivors, increasing access to programs by delivering them by telerehabilitation systems that are capable of assessing and treating their side effects might be a useful tool . A recent review indicated that telerehabilitation can be an effective part of cancer care .…”

“…4 Taking into account the negative impact of disease on the quality of life of BC survivors, increasing access to programs by delivering them by telerehabilitation systems that are capable of assessing and treating their side effects might be a useful tool. 5,6 A recent review indicated that telerehabilitation can be an effective part of cancer care. 7 In terms of quality of life, Ligibel et al 8 observed significant improvement only in physical functioning but did not demonstrate that an exercise intervention had a significant effect on other variables.…”

Design for Multi-Dimensional Stages of Lymphoedema Self-Management

“…For some people those measurements are very critical and their main reason to see their specialists (Jeffs et al, 2016). E-Cuidate is a software that enables people to log measurements manually and share these with their therapists (Galiano-Castillo et al, 2014). Another approach is measuring the circumference continuously by a sensor embedded cuff (Fallahzadeh et al, 2015).…”

“…During face-to-face clinical assessments, lymphoedema specialists measure arm circumferences to evaluate the differences between two arms as well as keeping track of the progress. Galiano-Castillo et al (2014) design and assess a telerehabilitation system to monitor arm measurements of breast cancer survivors. A telehealth system is utilised with the help of a caregiver to measure and log circumferences, while talking with the specialist is enabled via videoconference.…”

“…Design has an important role in addressing those support needs and promoting healthy behaviour (Tsekleves & Cooper, 2017). Appropriate design can improve behavioural and clinical outcomes (Balaam et al, 2011;Moffatt & Murray, 2010;Nunes et al, 2015;Sawesi, Rashrash, Phalakornkule, Carpenter, & Jones, 2016), however, the everyday support needs of people with lymphoedema is rarely investigated in this context (Chamberlain, Wolstenholme, & Dexter, 2015;Galiano-Castillo et al, 2014).…”