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


CONCLUSIONS
Decongestive lymphatic therapy, combined with long-term self-management, is efficacious in treating patients with lymphedema of the extremity.
Szuba
A
A
Stanford Lymphedema Center, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA.
Cooke
J P
JP
Yousuf
S
S
Rockson
S G
SG
D001458:Bandages; D001943:Breast Neoplasms / Q000150:complications / Q000601:surgery; D002481:Cellulitis / Q000209:etiology / Q000534:rehabilitation; D003020:Clothing; D004322:Drainage; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000209:etiology / Q000451:nursing / Q000534:rehabilitation*; D010386:Pelvic Neoplasms / Q000150:complications / Q000601:surgery; D026741:Physical Therapy Modalities / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome