Edinburgh Napier University

  This paper describes a randomized controlled crossover study examining the effects of manual lymphatic
drainage (MLD) in 31 women with breast cancer-related lymphoedema. MLD is a type of massage used in
combination with skin care, support/compression therapy and exercise in the management of lymphoedema.
A modified version of MLD, referred to as simple lymphatic drainage (SLD), is commonly taught as a selfhelp
measure. There has been limited research into the efficacy of MLD and SLD. The study reported here
explores the effects of MLD and SLD on a range of outcome measures. The findings demonstrate that MLD
significantly reduces excess limb volume (difference, d = 71, 95% CI = 16–126, P = 0.013) and reduced dermal
thickness in the upper arm (d = 0.15, 95% CI = 0.12–0.29, P = 0.03). Quality of life, in terms of emotional
function (d = 7.2, 95% CI = 2.3–12.1, P = 0.006), dyspnoea (d = -4.6, 95% CI = -9.1 to -0.15, P = 0.04) and
sleep disturbance (d = -9.2, 95% CI = -17.4 to -1.0, P = 0.03), and a number of altered sensations, such as pain
and heaviness, were also significantly improved by MLD. The study provides evidence to support the use of
MLD in women with breast cancer-related lymphoedema. The limitations of the study are outlined and future
areas for study are highlighted.