{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T07:14:56Z","timestamp":1792826096773,"version":"4.5.0"},"reference-count":35,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000001","name":"national science foundation","doi-asserted-by":"publisher","award":["1R01CA214085-01"],"award-info":[{"award-number":["1R01CA214085-01"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Judges and Lawyers Breast Cancer Alert"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Integr Cancer Ther"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The-Optimal-Lymph-Flow (TOLF) intervention aims to promote lymph flow through therapeutic lymphatic exercises to relieve lymphatic pain, swelling, lymphedema symptoms, and to decrease lymph fluid levels among breast cancer survivors. To enhance the efficacy of the TOLF intervention, an innovative, intelligent, Kinect-enhanced lymphatic exercise intervention (Kinect-TOLF) was developed to teach patients to perform the lymphatic exercises correctly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This feasibility trial aimed to determine the feasibility, usability, and effects of the Kinect-TOLF on lymphatic pain, swelling, lymphedema symptoms, and lymph fluid levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A single-arm feasibility trial with a pre- and post-test design was employed to recruit 30 breast cancer survivors with persistent lymphatic pain or swelling. Patients received a single training session to learn how to perform the lymphatic exercises using the Kinect-TOLF program. Descriptive statistics, Wilcoxon signed-rank tests, t-test, Spearman\u2019s rank correlation coefficients, linear regressions, and Cohen\u2019s d were performed for data analysis. Qualitative data were assessed for common themes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The Kinect-TOLF was effective in training patients to perform the lymphatic exercises correctly with high user satisfaction. Significant reductions were found in scores of lymphatic pain ( Med\n                      <jats:sub>\u0394<\/jats:sub>\n                      \u2009=\u2009\u22121.00, CI\u2009 =\u2009[\u22121.5, \u22120.1], P\u2009=\u2009.004), arm\/hand swelling ( Med\n                      <jats:sub>\u0394<\/jats:sub>\n                      \u2009=\u2009\u22121.00, CI\u2009=\u2009[\u22121.5, \u22120.5], P\u2009=\u2009.004), total swelling ( Med\n                      <jats:sub>\u0394<\/jats:sub>\n                      \u2009=\u2009\u22121.5, CI\u2009=\u2009[\u22122.0, \u22121.0], P\u2009=\u2009.003), number of lymphedema symptoms ( M\n                      <jats:sub>\u0394<\/jats:sub>\n                      \u2009=\u2009\u22123.8, CI\u2009=\u2009[\u22125.5, \u22122.1], P\u2009&lt;\u2009.001), and lymphedema symptom severity ( M\n                      <jats:sub>\u0394<\/jats:sub>\n                      \u2009=\u2009\u22125.3, CI\u2009=\u2009[\u22129.5, \u22121.1], P\u2009=\u2009.016). A significant reduction in lymph fluid levels was found in mean L-Dex scores ( M\n                      <jats:sub>\u0394<\/jats:sub>\n                      \u2009=\u2009\u22122.68, CI\u2009=\u2009[\u22124.67, \u22120.69], P\u2009=\u2009.010). Greater decrease in mean L-Dex scores were found in patients with abnormal lymph fluid levels (L-Dex \u2265 7.1) ( M\n                      <jats:sub>\u0394<\/jats:sub>\n                      \u2009=\u2009\u22125.19, CI\u2009=\u2009[\u22121.75, \u22128.63], P\u2009=\u2009.008). Patients\u2019 qualitative feedback supported the results of the study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The Kinect-TOLF is safe, feasible, and effective in reducing lymphatic pain, swelling, lymphedema symptoms, and in decreasing lymph fluid levels. Future research should focus on a randomized clinical trial to confirm the unique or synergistic efficacy of the Kinect-TOLF in comparison with current lymphedema treatment and other forms of exercises or movement therapy. This study was registered in ClinicalTrials.gov with US ClinicalTrials.gov Identifier: NCT03999177.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15347354211026757","type":"journal-article","created":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T11:40:24Z","timestamp":1624448424000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["The Effects of Kinect-Enhanced Lymphatic Exercise Intervention on Lymphatic Pain, Swelling, and Lymph Fluid Level"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3891-0109","authenticated-orcid":false,"given":"Mei R.","family":"Fu","sequence":"first","affiliation":[{"name":"Boston College William F. 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Axelrod","sequence":"additional","affiliation":[{"name":"New York University School of Medicine, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber","family":"Guth","sequence":"additional","affiliation":[{"name":"New York University School of Medicine, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhipeng","family":"Fan","sequence":"additional","affiliation":[{"name":"New York University Tandon School of Engineering, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Sang","sequence":"additional","affiliation":[{"name":"New York University College of Arts and Science, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Miaskowski","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, CA, 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