title: [Topical problems of the diagnosis and rehabilitative treatment of lymphedema of the lower extremities].
abstract: The present review of the literature data highlights modern approaches to and major trends in diagnostics and conservative treatment of lymphedema of the lower extremities based on the generalized world experience. Patients with lymphedema of the lower extremities comprise a "difficult to manage" group because the disease is characterized by steady progression and marked refractoriness to various conservative therapeutic modalities creating problems for both the patient and the attending physician. Modern methods for the diagnosis of lymphedema are discussed with special reference to noninvasive and minimally invasive techniques (such as lymphoscintiography, computed tomography, MRT, laser Doppler flowmetry, etc.). During the last 20 years, combined conservative therapy has been considered as the method of choice for the management of different stages and forms of lymphedema of the lower extremities in foreign clinics. The basis of conservative therapy is constituted by manual lymph drainage (MLD), compression bandages using short-stretch materials, physical exercises, and skin care (using the method of M. Foldi). Also reviewed are the main physiobalneotherapeutic methods traditionally widely applied for the treatment of lymphedema of the lower extremities in this country. Original methods for the same purpose developed by the authors are described including modifications of cryotherapy, pulsed matrix laserotherapy, hydro- and balneotherapy. Mechanisms of their therapeutic action on the main pathogenetic factors responsible for the development of lymphedema (with special reference to lymph transport and formation) are discussed. The principles of combined application of physiotherapeutic methods for the rehabilitative treatment of patients presenting with lymphedema of the lower extremities are briefly substantiated. Special emphasis is laid on their influence on major components of the pathological process.
authors.forename: V A
authors.initials: VA
authors.lastname: Badtieva
authors.forename: T A
authors.initials: TA
authors.lastname: Kniazeva
authors.forename: T V
authors.initials: TV
authors.lastname: Apkhanova
mesh_terms: D001452:Balneology / Q000379:methods*; D003131:Combined Modality Therapy; D006801:Humans; D017078:Laser-Doppler Flowmetry; D007866:Leg / Q000000981:diagnostic imaging; D008208:Lymphatic System / Q000000981:diagnostic imaging / Q000502:physiology; D008209:Lymphedema / Q000175:diagnosis* / Q000534:rehabilitation*; D008220:Lymphography; D026741:Physical Therapy Modalities; D016896:Treatment Outcome; D014463:Ultrasonography