Lymphedema rehabilitation: Provision and practice patterns among service providers: National survey

Abstract

Information on the current practices and quantification of lymphedema service may be beneficial to promote and improve the current health care system.Therefore, this study aimed to describe the characteristics of lymphedema practitioners, and lymphedema patients' profiles, and provide a comprehensive picture of lymphedema service provision in Saudi Arabia. A cross-sectional study design used an online survey to gather data. The survey included information about demographic and professional characteristics of lymphedema practitioners, lymphedema profiles, questions on the services provided, and perceived barriers in providing services. Eighteen lymphedema practitioners (38%) responded to the survey. Most of the respondents were physical therapists (94%), who had completed 135 hours of basic training course, and were certified as lymphedema therapists (89%). Most of these practitioners were in Riyadh (58%), Jeddah (25%), and Dammam (17%). About 75% of patients seen by practitioners had secondary lymphedema, predominately breast cancerrelated lymphedema (47%). The average number of lymphedema practitioners per service is three. The perceived barriers reported included an inadequate number of certified therapists (100%), difficulties with transportation and lack of financial support (each; 72%), and limited space for lymphedema practice/ management (89%). The results suggest lymphedema practitioners provide reasonable services for lymphedema patients; however, services are still limited and needs are unmet. Therefore, more staffing is required to promote awareness of the condition and related services, to develop and implement appropriate educational strategies, and improve geographical and multidisciplinary coordination of the services in Saudi Arabia.

Integrating molecular biomarkers in breast cancer rehabilitation. What is the current evidence? A systematic review of randomized controlled trials

“…In this scenario, rehabilitation plays a key role in the management of BC survivors with growing evidence highlighting its positive effects in improving functional outcomes and psychosocial well-being of BC patients ( Reid-Arndt et al, 2009 ; Zaidi et al, 2017 ; Kudre et al, 2020 ; Sleight et al, 2022 ). Hence, rehabilitation might improve the symptoms of patients with breast cancer–related lymphedema ( Invernizzi et al, 2019 ; Michelotti et al, 2019 ; de Sire et al, 2021a ; Carretti et al, 2022 ; Muñoz-Alcaraz et al, 2022 ; Omar et al, 2022 ), cancer-related fatigue ( Wirtz and Baumann, 2018 ; Adams et al, 2019 ; Invernizzi et al, 2020b ; Marechal et al, 2020 ; Licht et al, 2021 ), axillary web syndrome ( de Sire et al, 2020 ; Ravichandran et al, 2020 ; Tay et al, 2021 ), aromatase inhibitor–induced arthralgia ( Harris et al, 2012 ; Winters-Stone et al, 2012 ; Grizzi et al, 2020 ), and cancer treatment–induced bone loss ( Invernizzi et al, 2020a ; de Sire et al, 2021b ; Pagnotti et al, 2021 ; Singh and Toohey, 2022 ). In addition to these encouraging approaches, the rehabilitation management of these disabling sequelae is still a challenge, and several questions remain unanswered about the most effective and tailored interventions in real-world clinical practice ( Invernizzi et al, 2020e ).…”