Effects of inpatient rehabilitation in leg lymphedema : a naturalistic prospective cohort study with intra-individual control of effects

Angst, Felix; Benz, Thomas; Lehmann, Susanne; Sándor, Peter S.; Wagner, Stephan

doi:10.1016/j.apmr.2023.06.001

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Effects of inpatient rehabilitation in leg lymphedema : a naturalistic prospective cohort study with intra-individual control of effects
Authors:	Angst, Felix Benz, Thomas Lehmann, Susanne Sándor, Peter S. Wagner, Stephan
et. al:	No
DOI:	10.1016/j.apmr.2023.06.001
Published in:	Archives of Physical Medicine and Rehabilitation
Volume(Issue):	104
Issue:	12
Page(s):	2035
Pages to:	2042
Issue Date:	16-Jun-2023
Publisher / Ed. Institution:	Elsevier
ISSN:	0003-9993 1532-821X
Language:	English
Subjects:	Lymphedema; SF-36; Complex decongestive therapy; Effect; Health-related quality of life; Rehabilitation
Subject (DDC):	615.82: Physical therapy
Abstract:	Objective: To quantify therapy-attributable effects of a comprehensive inpatient rehabilitation program for lower limb lymphedema (LLL) and to compare the levels of health-related quality of life (HRQL) to population-based norms. Design: Naturalistic prospective cohort study with intra-individual control of effects. Setting: Rehabilitation hospital. Participants: Patients with LLL (N=67; 46 women). Interventions: Comprehensive, multidisciplinary inpatient rehabilitation with 45-60 hours of therapy. Main outcome measures: Short Form 36 (SF-36) for HRQL, lymphedema-specific Freiburg Quality of Life Assessment for lymphatic disorders, Short Version (FLQA-lk), knee-specific Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), and Symptom Checklist-90Standard (SCL-90S). Observed pre/post rehabilitation effects were individually corrected by subtracting the home waiting-time effects and expressed as standardized effect sizes (ESs) and standardized response means (SRMs). Score differences to norms were quantified by standardized mean differences (SMDs). Results: Participants were on average aged 60.5 years, not yet obese, and had 3 comorbidities (n=67). The greatest improvement was in HRQL on the FLQA-lk with ES=0.767/SRM=0.718, followed by improvements in pain and function with ES/SRM=0.430-0.495 on the SF-36, FLQA-lk, and KOS-ADL (all P<.001). Vitality, mental health, emotional well-being, and interpersonal sensitivity improved most by ES/SRM=0.341-0.456 on all 4 measures (all P≤.003). Post rehabilitation scores were significantly higher than population norms on SF-36 bodily pain (SMD=1.140), vitality (SMD=0.886), mental health (SMD=0.815), and general health (SMD=0.444) (all P<.001), and comparable on the other scales. Conclusions: Those affected by LLL stages II and III benefited substantially from the intervention, attaining equal or higher levels of HRQL than expected compared with the general population norms. Multidisciplinary, inpatient rehabilitation should be recommended for LLL management.
URI:	https://digitalcollection.zhaw.ch/handle/11475/29607
Fulltext version:	Published version
License (according to publishing contract):	Licence according to publishing contract
Departement:	School of Health Sciences
Organisational Unit:	Institute of Physiotherapy (IPT)
Appears in collections:	Publikationen Gesundheit

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Angst, F., Benz, T., Lehmann, S., Sándor, P. S., & Wagner, S. (2023). Effects of inpatient rehabilitation in leg lymphedema : a naturalistic prospective cohort study with intra-individual control of effects. Archives of Physical Medicine and Rehabilitation, 104(12), 2035–2042. https://doi.org/10.1016/j.apmr.2023.06.001

Angst, F. et al. (2023) ‘Effects of inpatient rehabilitation in leg lymphedema : a naturalistic prospective cohort study with intra-individual control of effects’, Archives of Physical Medicine and Rehabilitation, 104(12), pp. 2035–2042. Available at: https://doi.org/10.1016/j.apmr.2023.06.001.

F. Angst, T. Benz, S. Lehmann, P. S. Sándor, and S. Wagner, “Effects of inpatient rehabilitation in leg lymphedema : a naturalistic prospective cohort study with intra-individual control of effects,” Archives of Physical Medicine and Rehabilitation, vol. 104, no. 12, pp. 2035–2042, Jun. 2023, doi: 10.1016/j.apmr.2023.06.001.

ANGST, Felix, Thomas BENZ, Susanne LEHMANN, Peter S. SÁNDOR und Stephan WAGNER, 2023. Effects of inpatient rehabilitation in leg lymphedema : a naturalistic prospective cohort study with intra-individual control of effects. Archives of Physical Medicine and Rehabilitation. 16 Juni 2023. Bd. 104, Nr. 12, S. 2035–2042. DOI 10.1016/j.apmr.2023.06.001

Angst, Felix, Thomas Benz, Susanne Lehmann, Peter S. Sándor, and Stephan Wagner. 2023. “Effects of Inpatient Rehabilitation in Leg Lymphedema : A Naturalistic Prospective Cohort Study with Intra-Individual Control of Effects.” Archives of Physical Medicine and Rehabilitation 104 (12): 2035–42. https://doi.org/10.1016/j.apmr.2023.06.001.

Angst, Felix, et al. “Effects of Inpatient Rehabilitation in Leg Lymphedema : A Naturalistic Prospective Cohort Study with Intra-Individual Control of Effects.” Archives of Physical Medicine and Rehabilitation, vol. 104, no. 12, June 2023, pp. 2035–42, https://doi.org/10.1016/j.apmr.2023.06.001.