Effects of Different Bandaging Methods for Treating Patients With Breast Cancer-Related Lymphedema

OBJECTIVE: To compare the treatment effects, satisfaction with the treatment, and performance improvement following bandage treatment using the spiral method and spica method for breast cancer-related lymphedema (BCRL).METHODS: A prospective study with 46 patients with BCRL was conducted. All patients were divided into either the spiral or spica group for non-elastic bandage therapy and received the same treatment for 2 weeks, apart from the group-specific bandaging method used. For both groups, the Quality of Life Instrument score before treatment, changes in the volume of lymphedema limb and the Disability of the Arm, Shoulder, and Hand (DASH) score before and after treatment, and treatment satisfaction after treatment were compared. The Student t-test was used to compare the parameters between the two different bandage methods.RESULTS: With respect to the treatment outcomes, total volume reduction and proximal part volume reduction after treatment were 98.0±158.3 mL and 56.0±65.4 mL in the spiral method group and 199.0±125.1 mL and 106.1±82.2 mL in the spica method group, respectively. Therefore, the spica method group showed a significantly better improvement (p < 0.05). The DASH score changes after treatment showed that the spiral group score increased by 3.8±5.4 and the spica group score increased by 7.7±6.1; thus, a significantly better improvement was noted in the spica group (p < 0.05).CONCLUSION: The spica method indicated better volume reduction and DASH score improvement than the spiral method. Therefore, the spica method may be more effective for treating patients with BCRL.

The validity and reliability of DDST II and Bayley III in children with language development delay

@#Objective: To analyze and compare the performance of the language sectors in the Denver Developmental Screening Test II (DDST II) and the Bayley Scales of Infant Development III (Bayley III) test with that of the Sequenced Language Scale for Infants (SELSI). Methods: Retrospective medical chart reviews including the Bayley III, DDST II and SELSI were conducted for 35 infants suspected to have delayed language development. More than 1 caution or fail in the DDST II-language sector (DLS) and Bayley III-language sector (BLS) score below 7were regarded as delayed language development. The sensitivity, specificity, positive predictive value, and negative predictive value of the DLS and BLS were analyzed. The degree of agreement between the Bayley III-receptive language sector (BRLS) or Bayley III-expressive language sector (BELS), DLS and SELSI was assessed by Cohen’s kappa. Pearson’s correlation between the Bayley III and SELSI was performed. Results: The DLS and BELS showed high sensitivity, while the BRLS showed low sensitivity. The BRLS showed very high specificity and the BELS showed high specificity; in contrast, the DLS showed low specificity. Cohen’s kappa for the BRLS and DLS with the SELSI indicated moderate, while the value for the BELS indicated good agreement. The equivalent age as assessed by the BRLS or BELS was significantly associated with that assessed by the SELSI. Conclusion: We propose that the DDST II is a useful screening test to identify infants with delayed language development. But the BLS cannot replace the SELSI in the evaluation of language development.