***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Goals of workThe purpose of this study is to compare the treatment and retention effects between st and ard decongestive lymphatic therapy ( DLT ) combined with pneumatic compression ( PC ) and modified DLT , in which the use of a short-stretch b and age is replaced with the use of Kinesio tape ( K-tape ) combined with PC . Material s and methods Forty-one patients with unilateral breast-cancer-related lymphedema for at least 3 months were r and omly grouped into the DLT group ( b and age group , N = 21 ) or the modified DLT group ( K-tape group , N = 20 ) . Skin care , 30-min manual lymphatic drainage , 1-h pneumatic compression therapy , application of a short-stretch b and age or K-tape for each group , and a 20-min physical therapy exercise were given during every treatment session . Patient evaluation items included physical therapy assessment , limb size , water composition of the upper extremity , lymphedema-related symptoms , quality of life , and patients ’ acceptance to the b and age or tape . Main results There was no significant difference between groups in all outcome variables ( P > 0.05 ) through the whole study period . Excess limb size ( circumference and water displacement ) and excess water composition were reduced significantly in the b and age group ; excess circumference and excess water composition were reduced significantly in the tape group . The acceptance of K-tape was better than the b and age , and benefits included longer wearing time , less difficulty in usage , and increased comfort and convenience ( P < 0.05 ) . Conclusions The study results suggest that K-tape could replace the b and age in DLT , and it could be an alternative choice for the breast-cancer-related lymphedema patient with poor short-stretch b and age compliance after 1-month intervention . If the intervention period was prolonged , we might get different conclusion . Moreover , these two treatment protocol s are inefficient and cost time in application . More efficient treatment protocol is needed for clinical practice BACKGROUND Lymphedema following breast cancer treatment is one of the most morbid conditions affecting breast cancer survivors . Currently , no therapy completely cures this condition . Comprehensive Decongestive Therapy ( CDT ) , a novel physiotherapeutic method offers promising results in managing this condition . This therapy is being widely used in the West . Till date , there are no studies evaluating the effectiveness and feasibility of this therapy in the east . MATERIAL S AND METHODS The therapeutic responses of 25 patients with postmastectomy lymphedema were analyzed prospect ively in this study . Each patient received an intensive phase of therapy for eight days from trained physiotherapists , which included manual lymphatic drainage , multi layered compression b and aging , exercises , and skin care . Instruction in self management techniques were given to the patients on completion of intensive therapy . The patients were followed up for three months . Changes in the volume of the edematous limb were assessed with a geometric approximation derived from serial circumference measurements of the limb and by water displacement volumetry . Changes in skin and sub cutis thickness were assessed using high frequency ultrasound . RESULTS The reduction in limb volume observed after therapy was 32.3 % and 42 % of the excess , by measurement and volumetry , respectively . The maximum reduction was obtained after the intensive phase . The reduction in skin and subcutis thickness of the edematous limb followed the same pattern as volume reduction . Patients could maintain the reduction obtained by strictly following the protocol s of the maintenance phase . CONCLUSIONS CDT combined with long-term self management is effective in treating post mastectomy lymphedema . The tropical climate is a major factor limiting the regular use of b and ages by the patients Background Women who develop secondary arm lymphoedema subsequent to treatment associated with breast cancer require life-long management for a range of symptoms including arm swelling , heaviness , tightness in the arm and sometimes the chest , upper body impairment and changes to a range of parameters relating to quality of life . While exercise under controlled conditions has had positive outcomes , the impact of yoga has not been investigated . The aim of this study is to determine the effectiveness of yoga in the physical and psycho-social domains , in the hope that women can be offered another safe , holistic modality to help control many , if not all , of the effects of secondary arm lymphoedema . Methods and design A r and omised controlled pilot trial will be conducted in Hobart and Launceston with a total of 40 women receiving either yoga intervention or current best practice care .  Intervention will consist of eight weeks of a weekly teacher-led yoga class with a home-based daily yoga practice delivered by DVD . Primary outcome measures will be the effects of yoga on lymphoedema and its associated symptoms and quality of life . Secondary outcome measures will be range of motion of the arm and thoracic spine , shoulder strength , and weekly and daily physical activity . Primary and secondary outcomes will be measured at baseline , weeks four , eight and a four week follow up at week twelve . Range of motion of the spine , in a self-nominated group , will be measured at baseline , weeks eight and twelve . A further outcome will be the women ’s perceptions of the yoga collected by interview at week eight . Discussion The results of this trial will provide information on the safety and effectiveness of yoga for women with secondary arm lymphoedema from breast cancer treatment . It will also inform methodology for future , larger trials . Trial registration The incidence of breast cancer (BC)‐related lymphedema ( LE ) ranges from 7 % to 47 % . Successful management of LE relies on early diagnosis using sensitive measurement techniques . In the current study , the authors demonstrated the effectiveness of a surveillance program that included preoperative limb volume measurement and interval postoperative follow‐up to detect and treat sub clinical LE Objective : To compare the long-term efficacy of pneumatic compression and low-level laser therapies in the management of postmastectomy lymphoedema . Design : R and omized controlled trial . Setting : Department of Physical Medicine and Rehabilitation of Cukurova University , Turkey . Subjects : Forty-seven patients with postmastectomy lymphoedema were enrolled in the study . Interventions : Patients were r and omly allocated to pneumatic compression ( group I , n=24 ) and low-level laser ( group II , n=23 ) groups . Group I received 2 hours of compression therapy and group II received 20 minutes of laser therapy for four weeks . All patients were advised to perform daily limb exercises . Main measures : Demographic features , difference between sum of the circumferences of affected and unaffected limbs ( ▵ C ) , pain with visual analogue scale and grip strength were recorded . Results : Mean age of the patients was 48.3 ( 10.4 ) years . ▵ C decreased significantly at one , three and six months within both groups , and the decrease was still significant at month 12 only in group II ( P = 0.004 ) . Improvement of group II was greater than that of group I post treatment ( P = 0.04 ) and at month 12 after 12 months ( P = 0.02 ) . Pain was significantly reduced in group I only at posttreatment evaluation , whereas in group II it was significant post treatment and at follow-up visits . No significant difference was detected in pain scores between the two groups . Grip strength was improved in both groups , but the differences between groups were not significant . Conclusions : Patients in both groups improved after the interventions . Group II had better long-term results than group I. Low-level laser might be a useful modality in the treatment of postmastectomy lymphoedema We examined the effects of low stretch compression b and aging ( CB ) alone or in combination with manual lymph drainage ( MLD ) in 38 female patients with arm lymphedema after treatment for breast cancer . After CB therapy for 2 weeks ( Part I ) , the patients were allocated to either CB or CB + MLD for 1 week ( Part II ) . Arm volume and subjective assessment s of pain , heaviness and tension were measured . The mean lymphedema volume reduction for the total group during Part I was 188 ml ( p < 0.001 ) , a mean reduction of 26 % ( p < 0.001 ) . During Part II the volume reduction in the CB + MLD group was 47 ml ( p < 0.001 ) and in CB group 20 ml . These differences were not significant ( p = 0.07 ) . A percentage reduction of 11 % ( p < 0.001 ) in the CB + MLD group and 4 % in the CB group was significantly different ( p = 0.04 ) . In both the CB and the CB + MLD group , a decrease of feeling of heaviness ( p < 0.006 and p < 0.001 , respectively ) and tension ( p < 0.001 for both ) in the arm was found , but only the CB + MLD group showed decreased pain ( p < 0.03 ) . Low stretch compression b and aging is an effective treatment giving volume reduction of slight or moderate arm lymphedema in women treated for breast cancer . Manual lymph drainage adds a positive effect We compared manual lymph drainage ( MLD ) with sequential pneumatic compression ( SPC ) for treatment of unilateral arm lymphedema in 28 women previously treated for breast cancer . After 2 weeks of therapy with a st and ard compression sleeve ( Part I ) with maintenance of a steady arm volume , each patient was r and omly assigned to either one of two treatment regimens ( Part II ) . MLD was performed according to the Vodder technique for 45 min/day and SPC was performed with a pressure of 40 - 60 mmHg for 2 hours/day . Both treatments were carried out for 2 weeks . Arm volume was measured by water displacement . Arm mobility , strength , and subjective assessment s were also determined . Lymphedema was reduced by 49 ml ( 7 % reduction ) ( p = 0.01 ) in the total group during Part I. During Part II , the  MLD  group decreased by 75 ml ( 15 % reduction ) ( p < 0.001 ) and the SPC group by 28 ml ( 7 % reduction ) ( p = 0.03 ) . The total group reported a decrease of tension ( p = 0.004 ) and heaviness ( p = 0.01 ) during Part I. During Part II , only the MLD group reported a further decrease of tension ( p = 0.01 ) and heaviness ( p = 0.008 ) . MLD and SPC each significantly decreased arm volume but no significant difference was detected between the two treatment methods Lymphedema is a chronic and progressive long-term adverse effect of breast cancer treatment commonly defined by swelling of the affected arm . Current clinical guidelines indicate that women with and at risk for lymphedema should protect the affected arm from overuse . In clinical practice , this often translates into risk aversive guidance to avoid using the arm . This could lead to a disuse pattern that may increase the likelihood of injury from common activities of daily living . Further , such guidance poses an additional barrier to staying physically active , potentially translating to weight gain , which has been shown to be associated with worse clinical course for women with lymphedema . We hypothesize that a program of slowly progressive strength training with no upper limit on the amount of weight that may be lifted would gradually increase the physiologic capacity of the arm so that common activities represent a decreasing percentage of maximal capacity . Theoretically , this increased capacity should decrease the risk that daily activities put stress on the lymphatic system of the affected side . The Physical Activity and Lymphedema ( PAL ) Trial is a recently completed r and omized controlled exercise intervention trial that recruited 295 breast cancer survivors ( 141 with lymphedema at study entry , 154 at risk for lymphedema at study entry ) . The purpose of this report is to provide detail regarding the study design , statistical design , and protocol of the PAL trial Background Secondary arm lymphoedema continues to affect at least 20 % of women after treatment for breast cancer requiring lifelong professional treatment and self-management . The holistic practice of yoga may offer benefits as an adjunct self-management option . The aim of this small pilot trial was to gain preliminary data to determine the effect of yoga on women with stage one breast cancer-related lymphoedema ( BCRL ) . This paper reports the results for the primary and secondary outcomes . Methods Participants were r and omised , after baseline testing , to receive either an 8-week yoga intervention ( n = 15 ) , consisting of a weekly 90-minute teacher-led class and a 40-minute daily session delivered by DVD , or to a usual care wait-listed control group  ( n = 13 ) . Primary outcome measures were : arm volume of lymphoedema measured by circumference and extra-cellular fluid measured by bioimpedance spectroscopy . Secondary outcome measures were : tissue in duration measured by tonometry ; levels of sensations , pain , fatigue , and their limiting effects all measured by a visual analogue scale ( VAS ) and quality of life based on the Lymphoedema Quality of Life Tool ( LYMQOL ) . Measurements were conducted at baseline , week 8 ( post-intervention ) and week 12 ( four weeks after cessation of the intervention ) . Results At week 8 , the intervention group had a greater decrease in tissue in duration of the affected upper arm compared to the control group ( p = 0.050 ) , as well as a greater reduction in the symptom sub-scale for QOL ( p = 0.038 ) . There was no difference in arm volume of lymphoedema or extra-cellular fluid between groups at week 8 ; however , at week 12 , arm volume increased more for the intervention group than the control group ( p = 0.032 ) . Conclusions An 8-week yoga intervention reduced tissue in duration of the affected upper arm and decreased the QOL sub-scale of symptoms . Arm volume of lymphoedema and extra-cellular fluid did not increase . These benefits did not last on cessation of the intervention when arm volume of 
    Output:
    
Exercise seems beneficial in reducing oedema volume in BCRL .
IPC seems beneficial in helping to reduce the oedema volume in the acute phase of treatment .
Compression sleeves do not aid in the volume reduction in the acute phase ; however , they do prevent additional swelling