The Relationship Between Disease Variables, Pain Coping, and Functional Status of Patients with Lower Extremity Lymphedema.

Abstract

The purpose of this study is to investigate the relationship between reported symptoms, functional outcomes, and pain coping mechanisms in participants with lower limb lymph-edema. This research has been designed as cross-sectional. Participants' age, sex, height, weight, pain, tightness, and stiffness levels reported by the participants were documented with a 10 cm visual analogue scale. The Pain Coping Inventory scale has been used to evaluate coping strategies. Functional status was measured with timed-up-and-go test (TUGT), six-minute walk test (6MWT), and quadriceps muscle strength measurement with a hand-held dynamometer. The functional outcomes were also measured in a healthy control group. The difference in muscle strength in both lower extremities was evaluated using the t-test, and the correlations were assessed using the Spearman correlation test. Twenty-eight participants with lymphedema (PWL) and 23 controls were included in the study. Twenty-three of the PWL were female (82%). The mean age of the PWL was 54.43 ± 14.12, and the mean body mass index was 33.84 ± 6.17. There were no significant differences between the PWL and healthy controls regarding age and sex. The mean muscle strength of the affected lower extremity was 4.21 ± 1.10 kgs and was significantly lower compared to the contralateral lower extremity (6.10 ± 2.98 kgs) and control group (10.92 ± 1.25 kgs) (p<0.05 and p=0.007 respectively). In functional outcomes, TUGT was significantly worse in PWL when compared to the control group (11.17 ± 3.28 seconds vs 9.04 ± 1.33 seconds, p=0.004). A significant correlation was observed between the TUGT result and the level of tightness felt by the PWL (r= 0.43, p=0.02). There were significant correlations between pain coping strategies and patient reported symptoms. No correlations were found between coping strategies and functional measurements. Lymphedema disrupts the functional status of the participants, and these functional disruptions may be related to symptoms reported by the participants. The correlation between pain coping strategies and patient reported tightness may indicate that tightness may be more influential on coping with pain, but further research is needed to determine a cause-and-effect relationship.