The agreement between three classification systems used to grade the severity of lymphedema in patients with upper and lower extremity lymphedema: A retrospective study

Background: Several classification systems are used to grade the severity of lymphedema. Their agreement with each other has not been reported. Objective: To evaluate the agreement between the American Physical Therapy Association (APTA) criteria, the criteria of Ramos et al., and the International Society of Lymphology (ISL) criteria in patients with upper and lower extremity lymphedema. Methods: A total of 156 patients (63 and 93 patients with upper and lower extremity lymphedema, respectively) were included. The circumference measurements and limb volume were measured. The severity of lymphedema of the patients was classified as mild, moderate, and severe lymphedema using the APTA criteria, the criteria of Ramos et al., and the ISL criteria. The agreement between the classification systems was assessed with Krippendorff's alpha. Results: An acceptable and poor agreement were found between the criteria in upper (Krippendorff's alpha > 0.667) and lower extremity lymphedema (Krippendorff's alpha 0.667), and a poor agreement was found among each comparison in lower extremity lymphedema (Krippendorff's alpha 0.667). Conclusions: Patients with upper extremity lymphedema classified according to these criteria can be assumed to be samples of the same population; however, patients with lower extremity lymphedema graded according to the ISL criteria may be included in a different classification when they grade with the APTA criteria and the criteria of Ramos et al

Psychometric properties of patient-reported outcome questionnaires for patients with musculoskeletal disorders of the shoulder

Purpose To evaluate the psychometric properties of self-administered patient-reported outcome (PRO) questionnaires which were used in non-surgical homogeneous populations with musculoskeletal shoulder disorders. Methods The included studies were identified using eligibility criteria. The methodological quality of each article was assessed using the COSMIN checklist. The psychometric properties of original versions and translated versions of PROs were also assessed. Results Twenty articles were included. Two musculoskeletal shoulder disorders were identified that met the selection criteria: rotator cuff disease and glenohumeral instability. A total of 11 PROs were identified. In general, the methodological quality of the included studies is fair or poor. The Western Ontario Rotator Cuff Index (WORC) and the Shoulder Pain and Disability Index (SPADI) are the most frequently evaluated PROs for patients with rotator cuff disease, and their psychometric properties seem to vary according to what language that they are in. For glenohumeral instability, the Western Ontario Shoulder Instability Index (WOSI) and the Oxford Instability Shoulder Score (OISS) are the most frequently evaluated PROs, and their psychometric properties seem to be adequate. Conclusion Using for rotator cuff disease is advised, for Norwegian users, the SPADI, WORC, Oxford Shoulder Score, and disabilities of the arm, shoulder and hand. Dutch and Persian users could use the WORC. For Greek speakers, the SPADI is recommended. Turkish users could use the rotator cuff quality-of-life measure. For glenohumeral instability, Dutch and Norwegian speakers could use the WOSI and the OISS. Italian, Japanese, and Turkish users could use the WOSI. For English users, the OISS and the Shoulder Rating Questionnaire are recommended

The efficacy of change in limb volume on functional mobility, health-related quality of life, social appearance anxiety, and depression in patients with lower extremity lymphedema

Objectives This study aims to investigate the impact of change in limb volume on the levels of functional mobility, health-related quality of life, social appearance anxiety, and depression before and after complex decongestive physiotherapy in patients with lower extremity lymphedema. Method Twenty-seven patients with unilateral lower extremity lymphedema were included. The treatment period was 20 sessions. The outcome measures were the limb volume, the Timed Up and Go test, the Short Form-36, the Social Appearance Anxiety Scale, and the Beck Depression Inventory. Results A statistically significant decrease in the limb volume (p 0.05). Conclusion The decrease in the limb volume improves the functional mobility, physical health-related quality of life, social appearance anxiety, and depression in patients with lower extremity lymphedema, but not the mental health-related quality of life

Detection of Helicobacter heilmannii type II and Helicobacter pylori in dogs and their role in the development of gastritis

The aim of this study was to detect the presence of Helicobacter pylori and Helicobacter heilmannii type II in dogs and evaluate the role of Helicobacter spp. in chronic gastritis. Gastroscopy was performed in a total of 40 dogs (22 symptomatic and 18 asymptomatic) admitted to the small animal clinic of Istanbul University. In this study, the density of spiral bacteria and the degree and type of gastritis by histopathology were determined. Rapid urease tests were performed on gastric biopsy samples, and the species identity was determined using nested polymerase chain reaction to assess for the presence of H. heilmannii type II and H. pylori. The relationship between symptoms and gastroscopic findings was significant (P < 0.001). Gastritis was diagnosed in 38 of the 40 dogs histopathologically, of which 71% were atrophic. Thirty-four dogs were found to be positive for H. heilmannii type II. Although general opinion indicates that dogs do not harbor H. pylori, 3 dogs with gastric symptoms and 1 asymptomatic dog were found positive for H. pylori in this study. No significant correlation was found between Helicobacter spp. density and gastritis severity. However, H. pylori had a high pathogenic effect as higher infiltration rates and increased intensity of mononuclear inflammatory cells and lymphoid follicles were observed in cases of H. pylori-related gastritis

Effect of Bandage Compliance on Upper Extremity Volume in Patients with Breast Cancer-Related Lymphedema

Background: Complex decongestive physiotherapy (CDP) is an effective treatment for patients with breast cancer-related lymphedema (BCRL). Bandaging is an important component of CDP. Although the literature suggests that bandages must be kept on for about 24 hours, some patients cannot tolerate keeping them on for this length of time. Also, it has been observed that limb volume decreased in patients who did not keep bandages on for 24 hours in clinical trials. But there is no evidence that this reduction in time is statistically significant. Our purpose was to compare the effectiveness of bandage compliance for a longer or a shorter period on limb volume in patients with BCRL. Methods and Results: We retroprospectively reviewed the medical records of 39 patients who received CDP. Twenty-eight eligible patients were divided into two groups, group 1 (n=18) and group 2 (n=10), according to the average number of hours of bandage compliance, which was 13-24 and 7-12 hours, respectively. The primary outcome was the change in limb volume between groups. The values for the limb volumes showed a statistically significant decrease in both groups. There was no significant difference in volume reduction between the groups. Conclusion: This study shows that keeping bandages on for between about 12 and 24 hours has the same effect on patients with BCRL as receiving CDP

The Effect of Education on Upper Extremity Function in Patients with Lymphedema after Breast Cancer Treatments

Background: The aim of this study was to evaluate the effects of education on the upper extremity functions of patients with lymphedema (LE) after breast cancer treatments

Effects of Aqua-Lymphatic Therapy on Lower Extremity Lymphedema: A Randomized Controlled Study

Background: The purpose of this study is to investigate the effects of the aqua-lymphatic therapy (ALT) on unilateral lower extremity lymphedema in the maintenance phase

Effects of Clinical Pilates Exercises on Patients Developing Lymphedema after Breast Cancer Treatment: A Randomized Clinical Trial

Objective: The aim of the present study was to compare the effects of clinical Pilates exercises with those of the standard lymphedema exercises on lymphedema developing after breast cancer treatment