Lymphedema Night-time Compression Trial

Methods/ Design: We conducted a parallel 3-arm, multi-centre randomized fast-track trial. Women were recruited from three centres in Canada and randomized to Group 1: Day-time compression garment alone (standard care), or Group 2: Day-time compression garment + night-time compression bandaging (CB), or Group 3: Day-time compression garment + use of a night-time compression system garment (NCSG). The primary outcome was the change in excess arm volume from baseline to 12 weeks.

Following the randomized trial intervention period, participants from all groups used a NCSG from weeks 13 to 24. Results: One hundred and twenty women were enrolled, 118 completed the randomized trial, and 114 completed the 24-week follow-up. Adherence to the application of night-time compression was 95% (±15) and 96% (±11) in the CB and NCSG groups, respectively.

Post-intervention, the addition of night-time compression was found to be superior to standard care for both absolute millilitre (p = 0.006) and percent reduction (p = 0.002) in excess arm lymphedema volume. Significant within group changes were seen for quality of life across all groups; however, no between group differences were found (p > 0.05). Discussion: The trial demonstrated a significant improvement in arm lymphedema volume from the addition of night-time compression whether through the application of compression bandaging or use of a night-time compression system garment.

Given the benefit and high adherence rates seen in the trial, we recommend early introduction of night-time compression as a self-management strategy for breast cancer related lymphedema.