Evaluation of complex physical therapy for lymphedema of the unilateral lower limbs
Ogawa, Yoshihiro The University of Tokushima|Tokushima Rehabilitation Hospital
Kitagawa, Tetsuya The University of Tokushima Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Hori, Takaki The University of Tokushima
Masuda, Yutaka The University of Tokushima
Kitaichi, Takashi The University of Tokushima Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Wakisaka, Yoshinari The University of Tokushima
Watanabe, Mie The University of Tokushima
Yasuda, Osamu The University of Tokushima
Kanoh, Masashi The University of Tokushima
Tominaga, Takashi The University of Tokushima
Saitoh, Katsuhiko Tokushima Rehabilitation Hospital
Katoh, Itsuo The University of Tokushima
complex physical therapy
manual lymph drainage
We evaluated the effectiveness of the complex physical therapy (CPT) for lymphedema of the unilateral lower limbs of eleven patients who had been admitted to Tokushima Rehabilitation Hospital. Ten patients were of secondary lymphedema, nine of which were after treatment of uterine cancer and one was of primary lymphedema. Our CPT consited of skin care, manual lymph drainage (MLD), compression therapy with elastic bandages or elastic stockings, and exercise therapy under compression.
MLD functionally operates to enhance the lymph drainage more proximally in both contralateral and ipsilateral truncal quadrants of the torso, then in the proximal limb, and only thereafter from the distal to proximal portion of the edematous extremity. Swelling ratio of all patients on admission was 26.9± 11.8% and that at discharge was 16.8±9.4%. Edema reduction ratio (ERR) of the entire patients was 41.5± 16.5%, and 81.8% of cases were recognized as effective, in which ERR showed more than 30% at discharge.
In a consensus document about the diagnosis and treatment of peripheral lymphedema in 1995, the International Society of Lymphology Executive Committee reported that most operations designed to alleviate peripheral lymphedema have not as yet been perfected or usually are still inferior to combined physiotherapy. At present lymphedema should be accurately diagnosed in the early stage and be treated with CPT correctly by clinicians who understand lymphedema thoroughly and are well trained.
Shikoku Acta Medica
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