Changes in lymphatic function after complex physical therapy for lymphedema.
Twenty-two extremities of 19 lymphedema patients (6 arms, 16 legs) were treated by 2 weeks of complex physical therapy (CPT) and self home maintenance therapy (bandage/wearing of elastic garment and exercise). In addition to the clinical response of volume reduction before and 3 months after CPT, we analyzed the functional changes of the peripheral lymphatic system by use of lymphoscintigraphy (LS). Before CPT, the main LS findings of lymphedema included dermal backflow (100%), absent or faintly visualized regional lymph nodes (95.5%), presence of collateral lymphatic vessels (68.2%), and no or barely visualized lymphatic vessels (27.3%). LS findings suggesting improved lymphatic function after CPT were a decrease in dermal backflow (72.7%), an increase in radioisotope uptake by lymphatic vessels (27.3%), and an increase in radioisotope uptake by lymph nodes (9.1%). 81.8% of limbs showed improved lymphoscintigraphic findings and no change in 9.1%. In the others (9.1%), LS findings appeared worse. There was, however, no correlation between LS "improvement" and the amount of limb volume reduction.
Hwang
J H
JH
Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Sungkyun kwan University, College of Medicine, Seoul, Korea.
Kwon
J Y
JY
Lee
K W
KW
Choi
J Y
JY
Kim
B T
BT
Lee
B B
BB
Kim
D I
DI
D000965:Antimony; D001458:Bandages; D003102:Colloids; D004322:Drainage; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008208:Lymphatic System / Q000503:physiopathology*; D008209:Lymphedema / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000534:rehabilitation*; D061305:Lymphoscintigraphy; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D017556:Technetium Compounds; D016896:Treatment Outcome
D003102:Colloids; D017556:Technetium Compounds; C019096:technetium Tc 99m antimony sulfide; D000965:Antimony