Comparison of Lower Extremity Lymphedema Patients and Healthy Individuals with Plantar Pressure Sense, Balance, and Fall Risk: A Pilot Study

Yıl 2023, Cilt: 40 Sayı: 2, 248 - 253, 19.07.2023

Duygu Korkem Yorulmaz , Büşra Pehlivan , Tezel Yıldırım Şahan

Öz

Background: Plantar pressure is sensed by the receptors on the sole. It is still not clear how the changes after the skin involvement and the effect of this on balance and fall risk in lower extremity lymphedema.
Purpose: To compare patients with lower extremity lymphedema and healthy individuals in terms of the plantar pressure sense, balance, and fall risk.
Methods: A total of 31 participants were included in the study. The plantar pressure sense was evaluated with the Semmes-Weinstein Monofilament Test, the balance was made with the Berg Balance Scale, and the fall risk was evaluated with the Tinetti Fall Efficacy Scale.
Results: When the plantar pressure sense of the lower extremity lymphedema group and healthy individuals were compared, differences were found (p<0.05). A significant difference was detected between the groups when the balance and fall values were compared (p<0.05). No significant results were detected when the affected and unaffected extremities were compared in terms of plantar pressure sense in patients with lower extremity lymphedema (p>0.05).
Conclusion: This study showed that patients who had lower extremity lymphedema had decreased plantar pressure sense and balance, and increased fall risk. Early detection of these parameters in patients with lymphedema and their management are important for rehabilitation.

Anahtar Kelimeler

Lymphedema, plantar pressure sense, balance, fall risk

Kaynakça

• 1- Wang CM, Lee SY, Hsu KF, Lin CF, Ma MC, Hsu YY. Psychometric evaluation of a Chinese version of Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema in women with gynaecological cancer surgery. Eur J Cancer Care. 2018; 27(6): e12940.
• 2- Iwersen LF, Sperandio FF, Toriy AM, Palu M, Medeiros da Luz C. Evidence-based practice in the management of lower limb lymphedema after gynecological cancer. Physiother Theory Pract. 2017; 33(1): 1-8.
• 3- Strzalkowski ND, Triano JJ, Lam CK, Templeton CA, Bent LR. Thresholds of skin sensitivity are partially influenced by mechanical properties of the skin on the foot sole. Physiol Rep. 2015; 3:pii:e12425.
• 4- Surmeli M, Cinar Ozdemir O. The effect of upper limb lymphedema in posture of patients after breast cancer surgery. J Back Musculoskelet Rehabil (Preprint). 2021; 1-9.
• 5- Voogd AC,Ververs JM, Vingerhoets A, Roumen H , Coebergh JW, Crommelin MA. Lymphoedema and reduced shoulder function as indicators of quality of life after axillary lymph node dissection for invasive breast cancer. Br J Surg. 2003; 90:76-81.
• 6- Citaker S, Gunduz AG, Guclu MB, Nazliel B, Irkec C, Kaya D. Relationship between foot sensation and standing balance in patients with multiple sclerosis. Gait Posture. 2011; 34(2): 275–278.
• 7- Kars HJ, Hijmans JM, Geertzen JH, Zijlstra W. The effect of reduced somatosensation on standing balance: a systematic review. J Diabetes Sci Technol. 2009; 3:931–43.
• 8- Eils E, Behrens S, Mers O, Thorwesten L, Völker K, Rosenbauma D. Reduced plantar sensation causes a cautious walking pattern. Gait Posture. 2004; 20: 54–60.
• 9- Zhang S, Li L. The differential effects of foot sole sensory on plantar pressure distribution between balance and gait. Gait Posture. 2013; 37(4): 532–535.
• 10- Basar S, Bakar, Keser İ, et a. Does Lymphedema Affect the Postural Stability in Women After Breast Cancer? Geriatric Rehabilitation. 2012; 28(4): 287–94.
• 11- Angin S, Karadibak D, Yavuzşen T, et al. Unilateral upper extremity lymphedema deteriorates the postural stability in breast cancer survivors. Contemp Oncol (Pozn). 2014; 18(4): 279–284.
• 12- Çelenay Toprak Ş, Kaya Özer D. Effects of Complex Decongestive Physiotherapy on Function, Posture and Balance in a Case with Lymphedema after Mastectomy. İzmir Kâtip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi. 2016; 1(2): 41-45.
• 13- Payette MC, Belanger C, Léveillé V, Grenier S. Fall-related psychological concerns and anxiety among community-dwelling older adults: Systematic review and meta-analysis. PLoS one. 2016; 11(4):1-17.
• 14- Bowman C, Piedalue K A, Baydoun M, Carlson LE. The quality of life and psychosocial implications of cancer-related lower-extremity lymphedema: a systematic review of the literature. J Clin Med. 2020; 9(10): 3200.
• 15- Doruk Analan P, Kaya E. Postural stability in patients with lower limb lymphedema. Lymphatic Res Biol. 2019; 17(6): 647-650..
• 16- Gabbard C, Hart S. A question of foot dominance. The Journal of General Psychology. 1996; 123(4): 289–296.
• 17- Kaulesar Sukul DM, den Hoed PT, Johannes EJ. Direct and indirect methods for the quantification of leg volume: Comparison between water displacement volumetry, the disk model method and the frustum sign model method, using the correlation coefficient and the limits of agreement. J. Biomed. Eng. Res. 1993; 15:477-480.
• 18- Cordero FI, Langa MJ, Cordero AF, Jimeno JM. Predictive factors of response to decongestive therapy in patients with breast-cancer-related lymphedema. Ann Surg Oncol. 2010; 17(3): 744-51.
• 19- International Society of Lymphology Executive Committee. The diagnosis and treatment of peripheral lymphedema, consensus document of the International Society of Lymphology. Lymphology. 2016; 49: 170-184.
• 20- Bell-Krotoski J, Tomancik E. The repeatability of testing with Semmes-Weinstein monofilaments. J Hand Surg Am. 1987; 12(1): 155-161.
• 21-21- Sahin F, Yilmaz F, Ozmaden A, Kotevolu N, Sahin T, Kuran B. Reliability and validity of the Turkish version of the Berg Balance Scale. J Geriatr Phys Ther. 2008; 31(1):32-7.
• 22- Bogle Thorbahn LD, Newton RA. Use of the Berg Balance Test to predict falls in elderly person. Phys Ther. 1996; 76: 576-585.
• 23- Lajoie V, Girard A, Guay M. Comparison of the reaction time, The Berg Scale and The ABC in non-fallers and fallers. Arch Gerontol Geriat. 2002; 35: 215-22.
• 24- Ulus Y, Durmus D, Akyol Y, Terzi Y, Bilgici A, Kuru O. Reliability and validity of the Turkish version of the falls efficacy scale international (FES-I) in community-dwelling older persons. Arch Gerontol Geriatr. 2012; 54: 429-433.
• 25- Yardley L, Beyer N, Hauer K, Kempen G, Piot-Zeiger C, Todd C. Development and Initial Validation of the Falls Efficacy Scale-International. Age and Aging. 2005; 34: 614-619.
• 26- Rossi RJ.. Applied biostatistics for the health sciences. John Wiley & Sons. 2022.
• 27- Passik SD, McDonald MV. Psychosocial aspects of upper extremity lymphedema in women treated for breast carcinoma. Cancer. 1998. 83:2817-20.
• 28- Sakorafas GH, Peros G, Cataliotti L, Vlastos G. Lymphedema following axillary lymph node dissection for breast cancer. Surg Oncol. 2006, 15:153-65.
• 29- Ergin G, Karadibak D, Sener HO, Gurpinar B. Effects of Aqua-Lymphatic Therapy on Lower Extremity Lymphedema: A Randomized Controlled Study. Lymphat Res Biol 2017; 15(3) 8. 8.
• 30- Baran E, Özçakar L, Özgül S, Aksoy S, Akbayrak T. Upper limb sensory evaluations and ultrasonographic skin measurements in breast cancer–related lymphedema receiving complex decongestive physiotherapy. Supportive Care in Cancer. 2021; 29(11): 6545-6553.
• 31- Dai M, Minematsu T, Ogawa Y, Takanishi Y, Sugama J, Sanada, H. 2021. Subjective thermal sensation effect of cool feeling compression stocking for patients with lower limb lymphedema: a preliminary pre-post study. Journal of Japanese Society of Wound, Ostomy and Continence Management. 2021; 25(1): 10-17.
• 32- Altas E U, Demirdal ÜS, The effects of post-mastectomy lymphedema on balance, Kinesiophobia and fear of falling. J Community Health Nurs. 2021; 38(2): 130-138.
• 33- Sun D, Yu Z, Chen J, Wang L, Han L, Liu, N. The value of using a SkinFibroMeter for diagnosis and assessment of secondary lymphedema and associated fibrosis of lower limb skin. Lymphatic Res Biol. 2017;15(1): 70-76.