Decongestive lymphatic therapy for patients with cancer-related or primary lymphedema


      PURPOSE: A prospective evaluation was undertaken to assess the efficacy of intensive, short-term decongestive lymphatic therapy coupled with focused patient instruction in long-term self-care for the management of lymphedema.
      METHODS: The therapeutic responses of 79 patients with lymphedema were analyzed prospectively. Each patient received intensive, short-term decongestive lymphatic therapy, with quantification of the extent and durability of the clinical response. Decongestive lymphatic therapy was performed by therapists trained in these techniques. The mean (±SD) duration of therapy was 8 ± 3 days. Instruction in self-management techniques was incorporated into the therapeutic regimen by day 3 of the patient’s treatment. The mean period of follow-up was 38 ± 52 days. Changes in the volume of the affected limb were assessed with a geometric approximation derived from serial measurements of circumference along the axis of the limb.
      RESULTS: The mean short-term reduction in limb volume was 44% ± 62% of the excess volume in the upper extremities and 42% ± 40% in the lower extremities. At follow-up, these results were adequately sustained: mean long-term excess volume reductions of 38% ± 56% (upper extremities) and 41% ± 27% (lower extremities) were observed.
      CONCLUSION: Decongestive lymphatic therapy, combined with long-term self-management, is efficacious in treating patients with lymphedema of the extremity.
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        • Foeldi M.
        Treatment of lymphedema.
        Lymphology. 1994; 27: 1-5
        • Morgan R.G.
        • Casley-Smith J.R.
        • Mason M.R.
        • Casley-Smith J.R.
        Complex physical therapy for the lymphoedematous arm.
        J Hand Surg [Br]. 1992; 17: 437-441
        • Casley-Smith J.R.
        • Casley-Smith J.R.
        Modern treatment of lymphoedema. I. Complex physical therapy.
        Austral J Dermatol. 1992; 33: 61-68
      1. The diagnosis, and treatment of peripheral lymphedema. Consensus document of the International Society of Lymphology Executive Committee. Lymphology. 1995;28:113–117.

      2. Boris M, Weindorf S, Lasinski B, Boris G. Lymphedema reduction by noninvasive complex lymphedema therapy. Oncology (Huntingt). 1994;8:95–106, 109–110.

        • Foeldi E.
        • Foeldi M.
        • Weissleder H.
        Conservative treatment of lymphedema of the limbs.
        Angiology. 1985; 36: 171-180
        • Goltner E.
        • Gass P.
        • Hass J.
        • Schneider P.
        The importance of volumetry, lymphscintigraphy and computer tomography in the diagnosis of brachial edema after mastectomy.
        Lymphology. 1988; 21: 134-143
        • Sitzia J.
        Volume measurement in lymphoedema treatment.
        Eur J Cancer Care (Engl). 1995; 4: 11-16
        • Senofsky G.M.
        • Moffat Jr, F.L.
        • Davis K.
        • et al.
        Total axillary lymphadenectomy in the management of breast cancer.
        Arch Surg. 1991; 126: 1336-1342
        • Hoe A.L.
        • Iven D.
        • Royle G.T.
        • Taylor I.
        Incidence of arm swelling following axillary clearance for breast cancer.
        Br J Surg. 1992; 79: 261-262
      3. Schunemann H, Willich N. Secondary lymphedema of the arm following primary therapy of breast carcinoma. Zentralbl Chir. 1992;117:220–225.

        • Segerstrom K.
        • Bjerle P.
        • Graffman S.
        • Nystrom A.
        Factors that influence the incidence of brachial oedema after treatment of breast cancer.
        Scand J Plast Reconstr Surg Hand Surg. 1992; 26: 223-227
        • Pappas C.J.
        • O’Donnell Jr, T.F.
        Long-term results of compression treatment for lymphedema.
        J Vasc Surg. 1992; 16: 555-564
        • Zelikowski A.
        • Haddad M.
        • Reiss R.
        The “Lympha-Press” intermittent sequential pneumatic device for the treatment of lymphedema.
        J Cardiovasc Surg. 1986; 27: 288-290
      4. Wozniewski M. Value of intermittent pneumatic massage in the treatment of upper extremity lymphedema. Pol Tyg Lek. 1991;46:550–552.

        • Johansson K.
        • Lie E.
        • Ekdahl C.
        • Lindfeldt J.
        A randomized study comparing manual lymph drainage with sequential pneumatic compression for treatment of postoperative arm lymphedema.
        Lymphology. 1998; 31: 56-64
        • Dini D.
        • Del Mastro L.
        • Gozza A.
        • et al.
        The role of pneumatic compression in the treatment of postmastectomy lymphedema. A randomized phase III study.
        Ann Oncol. 1998; 9: 187-190
        • Leduc O.
        • Leduc A.
        • Bourgeois P.
        • Belgrado J.P.
        The physical treatment of upper limb edema.
        Cancer. 1998; 83: 2835-2839
        • Foeldi E.
        Prevention of dermatolymphangioadenitis by combined physiotherapy of the swollen arm after treatment of breast cancer.
        Lymphology. 1996; 29: 91-94