Ridner, S.H., Fu, M.R., Wanchai, A., Stewart, B.R., Armer, J.M., & Cormier, J.N. (2012). Self-management of lymphedema: A systematic review of the literature from 2004 to 2011. Nursing Research, 61(4), 291–299.

To evaluate evidence of lymphedema self-care through a systematic review

Databases searched were PubMed, CINAHL, Cochrane Collaboration, PapersFirst, ProceedingsFirst, Worldcat, PEDro, National Guidelines Clearing House, ACP Journal Club, and Database of Abstracts of Reviews of Effects. Best Practice for the Management of Lymphoedema (Lymphedema Framework, 2006) terms were used as well as additional terms that were not stated. Inclusion criteria were not specified. Qualitats, grey literature, dissertations, live studies, and case reports were excluded.

The total references received was 47. Literature was evaluated and commented on using categories of PEP levels of evidence.

• The final number of studies included was 16.
• The sample range across studies was 10–1,449.
• Most studies were of breast cancer survivors.
• Only single therapies done via self-care were included. 

• Late effects
• Survivorship

Reviewed findings related to self-care interventions. No interventions met criteria for Recommended for Practice. Interventions that were Likely to Be Effective included full-body exercise and phase 2 complete decongestive therapy (CDT). Pneumatic compression devices, compression garments, infection management, self-monitoring, skin care, simple manual decongestive therapy, and weight reduction were categorized as Effectiveness Not Established. Aromatherapy was categorized as Effectiveness Unlikely.

Strongest evidence for effect is found for exercise and phase 2 CDT.

There were relatively few studies in the area of self-care interventions.

Findings suggested that self-care using exercise and CDT are likely to be effective for lymphedema self-management. Further research in other potential self-care interventions are needed.