TY - JOUR
T1 - The Effects of Kinect-Enhanced Lymphatic Exercise Intervention on Lymphatic Pain, Swelling, and Lymph Fluid Level
AU - Fu, Mei R.
AU - McTernan, Melissa L.
AU - Qiu, Jeanna M.
AU - Ko, Eunjung
AU - Yazicioglu, Simay
AU - Axelrod, Deborah
AU - Guth, Amber
AU - Fan, Zhipeng
AU - Sang, Anna
AU - Miaskowski, Christine
AU - Wang, Yao
N1 - Publisher Copyright:
© The Author(s) 2021.
PY - 2021
Y1 - 2021
N2 - Background: The-Optimal-Lymph-Flow (TOLF) intervention aims to promote lymph flow through therapeutic lymphatic exercises to relieve lymphatic pain, swelling, lymphedema symptoms, and to decrease lymph fluid levels among breast cancer survivors. To enhance the efficacy of the TOLF intervention, an innovative, intelligent, Kinect-enhanced lymphatic exercise intervention (Kinect-TOLF) was developed to teach patients to perform the lymphatic exercises correctly. Objectives: This feasibility trial aimed to determine the feasibility, usability, and effects of the Kinect-TOLF on lymphatic pain, swelling, lymphedema symptoms, and lymph fluid levels. Methods: A single-arm feasibility trial with a pre- and post-test design was employed to recruit 30 breast cancer survivors with persistent lymphatic pain or swelling. Patients received a single training session to learn how to perform the lymphatic exercises using the Kinect-TOLF program. Descriptive statistics, Wilcoxon signed-rank tests, t-test, Spearman’s rank correlation coefficients, linear regressions, and Cohen’s d were performed for data analysis. Qualitative data were assessed for common themes. Results: The Kinect-TOLF was effective in training patients to perform the lymphatic exercises correctly with high user satisfaction. Significant reductions were found in scores of lymphatic pain (MedΔ = −1.00, CI = [−1.5, −0.1], P =.004), arm/hand swelling (MedΔ = −1.00, CI = [−1.5, −0.5], P =.004), total swelling (MedΔ = −1.5, CI = [−2.0, −1.0], P =.003), number of lymphedema symptoms (MΔ = −3.8, CI = [−5.5, −2.1], P <.001), and lymphedema symptom severity (MΔ = −5.3, CI = [−9.5, −1.1], P =.016). A significant reduction in lymph fluid levels was found in mean L-Dex scores (MΔ = −2.68, CI = [−4.67, −0.69], P =.010). Greater decrease in mean L-Dex scores were found in patients with abnormal lymph fluid levels (L-Dex ≥ 7.1) (MΔ = −5.19, CI = [−1.75, −8.63], P =.008). Patients’ qualitative feedback supported the results of the study. Conclusions: The Kinect-TOLF is safe, feasible, and effective in reducing lymphatic pain, swelling, lymphedema symptoms, and in decreasing lymph fluid levels. Future research should focus on a randomized clinical trial to confirm the unique or synergistic efficacy of the Kinect-TOLF in comparison with current lymphedema treatment and other forms of exercises or movement therapy. This study was registered in ClinicalTrials.gov with US ClinicalTrials.gov Identifier: NCT03999177.
AB - Background: The-Optimal-Lymph-Flow (TOLF) intervention aims to promote lymph flow through therapeutic lymphatic exercises to relieve lymphatic pain, swelling, lymphedema symptoms, and to decrease lymph fluid levels among breast cancer survivors. To enhance the efficacy of the TOLF intervention, an innovative, intelligent, Kinect-enhanced lymphatic exercise intervention (Kinect-TOLF) was developed to teach patients to perform the lymphatic exercises correctly. Objectives: This feasibility trial aimed to determine the feasibility, usability, and effects of the Kinect-TOLF on lymphatic pain, swelling, lymphedema symptoms, and lymph fluid levels. Methods: A single-arm feasibility trial with a pre- and post-test design was employed to recruit 30 breast cancer survivors with persistent lymphatic pain or swelling. Patients received a single training session to learn how to perform the lymphatic exercises using the Kinect-TOLF program. Descriptive statistics, Wilcoxon signed-rank tests, t-test, Spearman’s rank correlation coefficients, linear regressions, and Cohen’s d were performed for data analysis. Qualitative data were assessed for common themes. Results: The Kinect-TOLF was effective in training patients to perform the lymphatic exercises correctly with high user satisfaction. Significant reductions were found in scores of lymphatic pain (MedΔ = −1.00, CI = [−1.5, −0.1], P =.004), arm/hand swelling (MedΔ = −1.00, CI = [−1.5, −0.5], P =.004), total swelling (MedΔ = −1.5, CI = [−2.0, −1.0], P =.003), number of lymphedema symptoms (MΔ = −3.8, CI = [−5.5, −2.1], P <.001), and lymphedema symptom severity (MΔ = −5.3, CI = [−9.5, −1.1], P =.016). A significant reduction in lymph fluid levels was found in mean L-Dex scores (MΔ = −2.68, CI = [−4.67, −0.69], P =.010). Greater decrease in mean L-Dex scores were found in patients with abnormal lymph fluid levels (L-Dex ≥ 7.1) (MΔ = −5.19, CI = [−1.75, −8.63], P =.008). Patients’ qualitative feedback supported the results of the study. Conclusions: The Kinect-TOLF is safe, feasible, and effective in reducing lymphatic pain, swelling, lymphedema symptoms, and in decreasing lymph fluid levels. Future research should focus on a randomized clinical trial to confirm the unique or synergistic efficacy of the Kinect-TOLF in comparison with current lymphedema treatment and other forms of exercises or movement therapy. This study was registered in ClinicalTrials.gov with US ClinicalTrials.gov Identifier: NCT03999177.
KW - breast cancer
KW - lymph fluid
KW - lymphatic
KW - lymphedema
KW - pain
KW - swelling
KW - symptoms
KW - Edema
KW - Humans
KW - Lymphedema/therapy
KW - Breast Neoplasms
KW - Exercise Therapy
KW - Pain
KW - Female
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U2 - 10.1177/15347354211026757
DO - 10.1177/15347354211026757
M3 - Article
C2 - 34160294
AN - SCOPUS:85108851264
SN - 1534-7354
VL - 20
JO - Integrative Cancer Therapies
JF - Integrative Cancer Therapies
ER -