Reliability and Reproducibility of Bandaging in Breast Cancer
Condition: Breast Cancer
MeSH terms: Breast Neoplasms
Study type: Interventional

Summary: 
      Functional Compressive Bandage (ECF) is a widely used therapeutic resource in the control of
      lymphedema resulting from the treatment of breast cancer, however, the effects inherent to
      the technique depend on the quality of the application. The aim of the study is to evaluate
      the reliability, reproducibility, and efficiency of treatment with different techniques in
      two studies. The first step aims to evaluate the reliability and reproducibility of the
      technique. The analysis of the pressure exerted by the four-layer bandage, applied by two
      evaluators previously trained and familiar with the ECF technique will perform the
      evaluations on the same volunteers in two moments, with an interval of one week between them.
      The intraclass correlation coefficient will be used to determine intra- and inter-examiner
      reliability, with its respective 95% confidence interval, standard error of measurement and
      minimum detectable change. The second stage aims to verify the efficiency of different ECF
      techniques in the functionality and circulation of the upper limb affected by lymphedema.
      This step is being performed by a single evaluator, and the ECF efficiency tested by the
      random application of two different techniques (spiral and eight), with a seven-day interval,
      and pressure assessment in mmHg. Upper limb functionality analysis is being performed using
      the Jebsen Taylor test performed before and with ECF on both limbs. The evaluation of the
      influence of the bandage in the circulation evaluated by Doppler ultrasound, before and after
      the test application. Member dominance assessed using the Edinburgh inventory.
    

Detailed description: 
      Functional Compressive Bandage (ECF) is a widely used therapeutic resource in the control of
      lymphedema resulting from the treatment of breast cancer, however, the effects inherent to
      the technique depend on the quality of the application. The aim of the study is to evaluate
      the reliability, reproducibility, and efficiency of treatment with different techniques in
      two studies. To this end, 50 volunteers will be evaluated, aged between 40 and 70 years,
      submitted to breast cancer treatment. The analyzes will be performed in two subprojects,
      conducted with randomized cross over design and seven days wash out period, so far 19
      volunteers were collected. The first step aims to evaluate the reliability and
      reproducibility of the technique. The analysis of the pressure exerted by the four-layer
      bandage, applied by two evaluators previously trained and familiar with the ECF technique
      will perform the evaluations on the same volunteers in two moments, with an interval of one
      week between them. The intraclass correlation coefficient (ICC2,1) will be used to determine
      intra- and inter-examiner reliability, with its respective 95% confidence interval, standard
      measurement error and minimum detectable change. The second stage aims to verify the
      efficiency of different ECF techniques in the functionality and circulation of the upper limb
      affected by lymphedema. This step is being performed by a single evaluator, and the ECF
      efficiency tested by the random application of two different techniques (spiral and eight),
      with a seven-day interval, and pressure assessment in mmHg. Upper limb functionality analysis
      is being performed using the Jebsen Taylor test performed before and with ECF on both limbs.
      The evaluation of the influence of the bandage in the circulation evaluated by Doppler
      ultrasound, before and after the test application. Member dominance assessed using the
      Edinburgh inventory. Partial data was verified by descriptive analysis with mean and standard
      deviation. Data processing was performed using SPSS® software, version 13.0 (Chicago, IL,
      USA). A significance level of 5% was considered. The information obtained in the study aims
      to show the partial results of the preliminary and descriptive evaluation of the physical
      therapy intervention in women affected by lymphedema resulting from breast cancer treatment.
    

Intervention name(s): functional compressive bandage
Intervention type(s): Other
Intervention description(s): The functional compressive bandage is being performed with the volunteer sitting with the upper limb homolateral to the surgery supported by a support. After hydration of the limb, a cotton mesh is being used to prevent friction of the 1 cm density foam band being wrapped around the limb. No therapeutic procedure is being performed prior to functional compressive bandage.
The bandage of the limb is being performed with 5 cm, 10 cm, 15 cm elastic cotton bandages from the fingers to the axillary region in four layers.
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Functional Compressive Bandage; Lymphedema; Physiotherapy