Twice-Weekly Complete Decongestive Physical Therapy in the Management of Secondary Lymphedema of the Lower Extremities

Karen M Holtgrefe

KM Holtgrefe, PT, DHS, OCS, is Instructor,
Department of Health Science, College of Mount St. Joseph, 5701 Delhi Rd, Cincinnati, OH 45233

*SELECTED EXCERPTS*

Plan of Care.
A limitation of MLB (Multi Level Bandaging) is that it is time consuming process. Applying the layers of bandages may take more than 30 minutes per extremity, not including the time needed to reroll the bandages when removing them. The multiple layers also reduce mobility at the ankle and knee. I felt that MLB of the BLE's would have been difficult and time consuming for the patient, would decrease adherence related to compression, and would have limited her ability to drive to and from therapy sessions...

The LegAssist TH is a custom-fit garment that is pulled onto the extremity. Circumferential Velcro straps are then tightened from the ankle to the proximal thigh. It takes approximately 10 minutes to put on 2 LegAssist TH garments compared with an hour for MLB. During this phase of therapy, they were worn 22 to 23 hours a day, with no problems reported by the patient.

Functional Activities
Several studies related to management of lymphedema with CDP have shown that the greatest reduction in volume occured during the first 2 weeks of therapy. This did not occur in this case. When assessing the percentage of change in the sum of the circumferential measurements, it appears that the greatest decreases in lymphedema occurred after the patient received the LegAssist TH during visit 6, 4 weeks after starting therapy...

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Contact
BiaCare Medical
Phone: 866-931-0876
Fax: 616-931-0052