Objective To explore the preventive effectiveness of early physiotherapy on arm lymphedema after modified radical mastectomy for breast cancer. Methods A total of 206 patients who underwent modified radical mastectomy for breast cancer in The First Affiliated Hospital of Henan University from June 2014 to June 2016, enrolled in this randomized controlled clinical trial. Then these patients were randomly divided into intervention group and control group equally. Patients in the control group received routine treatment, and the patients in the intervention group began to use the air pressure pump combined with the microwave physiotherapy on the second day after the radical surgery. The incidences of limb lymphedema in 6 months and 1 year after operation between the 2 groups were compared, and the influencing factors of arm lymphedema were explored. Results The clinical data of 195 patients were analyzed at end, including 99 patients of the intervention group and 96 patients of the control group. ① There were statistical significance in the incidences of arm lymphedema in 6 months and 1 year after operation between the 2 groups (P<0.05), that incidences of arm lymphedema in the intervention group were both lower than those of the control group at the2 time points [6 months after operation: 2.0% (2/99)vs. 9.4% (9/96); 1 year after operation: 5.1% (5/99) vs. 17.7% (17/96)]. ② The results of non-conditional logistic regression analysis shown that, age (OR=1.45, P=0.008), tumor location (OR=1.72, P<0.001), TNM stage (OR=2.01, P=0.033), the number of invasive axillary lymph nodes (OR=1.15, P=0.005), and postoperative radiotherapy (OR=1.23, P=0.016) were the influencing factors of arm lymphedema after modified radical mastectomy for breast cancer, patients with age older than 60 years, tumor position at the outside area, stage Ⅲ of TNM, the number of invasive axillary lymph nodes >5, and patients received radiotherapy after operation had high risk of arm lymphedema. Conclusion Early physiotherapy can effectively prevent the occurrence of arm lymphedema after modified radical mastectomy for breast cancer, and early physiotherapy should be performed for patients with high risk of arm lymphedema.
Objective To explore the effects of narrative intervention and different intervention models on children at risk for developmental language disorders (DLD). Methods Using a random number table method, thirty children at risk for DLD in Yuhua District, Changsha City, were selected from September to December 2024 and randomly assigned to three groups: individual group (n=10), peer group (n=10), and control group (n=10). The individual and peer groups (2-3 children per peer group) received a 20-hour narrative intervention, while the control group did not receive any intervention. The Little Frog, Where Are You? test was used to assess the children’s narrative abilities, and both global and local coherence error rates were analyzed. Results A total of 24 children were enrolled in the final analysis, including 7 in the individual group, 9 in the peer group, and 8 in the control group. Compared with pre-intervention levels, in the individual group, within-group differences in global and local coherence error rates at 1 week and 3 months post-intervention were statistically significant (all P<0.05) with large effect sizes (Cohen’s |d|>1); in the peer group, only the within-group difference in local coherence error rate at 1 week post-intervention reached statistical significance (P<0.05), with a large effect size (Cohen’s |d|>1); in the control group, within-group differences in global coherence error rate were statistically significant at both 1 week and 3 months post-intervention (both P<0.05), with large effect sizes (Cohen’s |d|>1). Between-group comparisons revealed that at 1 week post-intervention, statistically significant differences in local coherence error rates were observed between both intervention groups and the control group (both P<0.05), with large effect sizes (Cohen’s |d|>1); 3 months post-intervention, the difference in global coherence error rate between the individual group and the control group was statistically significant (P<0.05) and exhibited a large effect size (Cohen’s |d|>1); no statistically significant intergroup differences were identified in any other pairwise comparisons (all P>0.05). Conclusions Early narrative intervention has a preliminary positive effect on enhancing the narrative coherence in children at risk for DLD. In clinical practice, either individualized intervention or peer participatory intervention can be used independently, or the advantages of both approaches can be integrated by alternating individual and peer collaborative interventions.