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Τετάρτη, 29 Οκτωβρίου 2014

Lymphoedema and Reflexology Research Project

The results of the Tenovus funded research into lymphoedema and the reflexology are currently being finalised. On 9th September a meeting was held with all those who took part, as well as representatives from Tenovus. The research team and the reflexology practitioners (Philip Harris, Judith Whatley, Rachael Street, Sally Kay, Virginia Harding and Elaine Allison) presented the preliminary results, and thanked the participants for their involvement, and Tenovus for their support.

An overview of the project and the main results is given below. The members of Tenovus indicated that they were keen to build on the success of this pilot project and develop further research in the area.

The Project

The project was a pilot study to explore the use of a particular technique of reflexology called Reflexology Lymphatic Drainage (RLD) for people with swelling of the arm (lymphoedema) as a result of surgery for breast cancer. Twenty six women who had undergone breast and armpit surgery and had consequently experienced swelling in one arm were recruited to three sites in South Wales (5 in Tredegar, 6 in Bridgend and 15 in Cardiff).

For two weeks, they had the volumes of both their arms measured without receiving reflexology treatment, this formed a baseline measure. This was followed by four weekly sessions of RLD, where their arms were measured before and after each of these reflexology sessions. In the final session of the study, their arms were measured again without RLD. Each participant was also asked to complete a short validated questionnaire, at the start and the end of the study ont their main concerns and their wellbeing. In the last session, the participants were interviewed about their experiences and were asked how taking part in the study had impacted on them. 

Outcomes of the Project

The Swelling Reduced
When the volumes of the participants’ normal arms were compared with their swollen arms, the data showed that all 26 participants (100%) who took part in the study had reductions in the swelling of their swollen arm. Those with the largest amount of swelling in the affected arm tended to lose most fluid.

The statistical tests used showed that the difference in the volume of the participants’ swollen arms after the reflexology treatments was considerable: the average difference between the volumes of the swollen and normal arms at the start of the study was 349 ml, at the end of the study the average difference was 223 ml, a reduction of 126 ml (about 36%).

The Treatment was Helpful
The information from the questionnaires showed that the participants identified two main concerns: ‘Swelling’ and ‘Pain’. On average, there was a meaningful improvement in these two main concerns following the reflexology. The participants also indicated that their general wellbeing improved.

When asked to rate the degree of helpfulness of the reflexology on a scale of 1 to 6 (where 1 meant ‘not very helpful at all’ and 6 meant ‘extremely helpful’), 19 of the 26 participants rated their experience as extremely helpful (6), and none of the remainder scored below a 3.

What the Participants Said
In the interviews, the participants talked about how their lymphoedema had affected them on both a physical and a psychological level. For example:

“I was really quite embarrassed about it actually, I know it’s stupid, but it really was to the extent that I almost felt deformed because my arm was that bad.”

 “It was a real nightmare. It was really painful and was like a blood pressure cuff permanently on my arm, so I had that permanent throbbing.”

After the study, they felt that the treatment had helped them on a number of levels. Being able to wear their usual clothing and resuming activities that had been closed off to them were just two of the areas positively impacted by taking part in the study. Comments included:

 “I can fit into blouses that I couldn’t fit into before because the swelling isn’t so bad.  And my jackets, leather jackets, you know, sometimes you feel a little bit restricted around the arm, they now fit comfortably.”

“I enjoy gardening and I did a little bit last week which I haven’t done for a long time, so that was good, I enjoyed doing that - the fact that I’d achieved something. I was always afraid to do it before.”

Impact of the research

Overall, the success of the study was measured in terms of meaningful changes in the volumes of the swollen arms and in the views of the participants about their experiences and the helpfulness of the reflexology treatments.

The research could have significant benefits for those suffering from lymphoedema after surgery for breast cancer. Lymphoedema services can offer limited access to MLD (Manual Lymphatic Drainage) for women with lymphoedema of the arm. The reflexology technique could offer an additional type of treatment which might allow patients to seek out an RLD trained reflexologist in their own area. This may help to reduce pressure on the lymphoedema service and goes some way to indicate that further research using clinical trials is warranted.