Complex Physical Therapy for Lymphoedema of the Limbs

Abstract

Summary A total of 208 women aged 17 to 83 years (mean 50.8) were treated for lymphoedema with complex physical therapy (CPT) – intermittent pneumatic compression, exercise and manual lymph drainage. Of these patients, 188 (90%) had secondary lymphoedema of the upper limb following radical mastectomy; 20 (10%) had lymphoedema of the lower limb, of whom 12 patients had secondary lymphoedema following lymphangectomy for malignant melanoma and eight patients had lymphoedema of unknown origin. The volume of the upper limbs and circumferences at nine levels of the lower limbs were measured before and after CPT. Complete resolution of lymphoedema of the upper limb was achieved in 32 patients (17%). The average decrease in lymphoedema was 43% in patients with minimal oedema, 33% in those with moderate oedema, and 19% in women with severe oedema. Complete resolution of primary lymphoedema of the lower limb was achieved in four patients. Average decrease in circumference was 13%. Complete resolution of secondary oedema of the lower limb was obtained in four patients with an average decrease in circumference of 23%. CPT is an effective form of conservative treatment for limb lymphoedema, particularly in patients with secondary lymphoedema of the upper limb. Reduction depends on the type of lymphoedema and the limb affected, with smaller effects demonstrated in lower limbs. The combination of intermittent pneumatic compression and manual techniques improves the results of treatment of lymphoedema. A total of 208 women aged 17 to 83 years (mean 50.8) were treated for lymphoedema with complex physical therapy (CPT) – intermittent pneumatic compression, exercise and manual lymph drainage. Of these patients, 188 (90%) had secondary lymphoedema of the upper limb following radical mastectomy; 20 (10%) had lymphoedema of the lower limb, of whom 12 patients had secondary lymphoedema following lymphangectomy for malignant melanoma and eight patients had lymphoedema of unknown origin. The volume of the upper limbs and circumferences at nine levels of the lower limbs were measured before and after CPT. Complete resolution of lymphoedema of the upper limb was achieved in 32 patients (17%). The average decrease in lymphoedema was 43% in patients with minimal oedema, 33% in those with moderate oedema, and 19% in women with severe oedema. Complete resolution of primary lymphoedema of the lower limb was achieved in four patients. Average decrease in circumference was 13%. Complete resolution of secondary oedema of the lower limb was obtained in four patients with an average decrease in circumference of 23%. CPT is an effective form of conservative treatment for limb lymphoedema, particularly in patients with secondary lymphoedema of the upper limb. Reduction depends on the type of lymphoedema and the limb affected, with smaller effects demonstrated in lower limbs. The combination of intermittent pneumatic compression and manual techniques improves the results of treatment of lymphoedema.