Manual lymphatic drainage treatment for lymphedema: a systematic review of the literature.
Level 1 - systematic review of randomized trials
Systematic review of 17 controlled studies
PubMed 32803533 · doi:10.1007/s11764-020-00928-1
What was done
Authors conducted a systematic review searching Embase, PubMed, CINAHL Complete, and the Cochrane Central Register of Controlled Trials for studies comparing manual lymphatic drainage (MLD) against another intervention or control in individuals at risk of or diagnosed with lymphedema. Methodological quality was assessed using the PEDro scale.
What was found
Seventeen studies were included, covering 869 participants (867 female, 2 male), all examining breast cancer-related lymphedema. No quantitative numerical outcomes or pooled statistics were reported in the abstract. Findings were conflicting across trials: some demonstrated improvements in volume reduction, quality of life, symptom burden, and reduced lymphedema incidence in at-risk patients, while other trials found no preventive benefit and no additional benefit when adding MLD to complex decongestive therapy.
Why it matters
This review clarifies that while MLD may offer benefit in prevention or mild early-stage breast cancer-related lymphedema, current evidence does not support its added value in standard complex decongestive therapy for moderate-to-severe disease.
Limits
The evidence base is restricted exclusively to breast cancer-related lymphedema and is almost entirely female. The abstract notes that included studies frequently suffered from methodological limitations, exhibited contradictory results, and lacked sufficient consistency to support firm clinical conclusions.