Effectiveness of complex physical therapy of lymphoedema - evaluation in clinical practice
Journal Title: Rehabilitacja Medyczna - Year 2006, Vol 10, Issue 2
Abstract
Combined Physical Therapy (CPT) is an effective method in the therapy of developed limb lymphoedema. It results in marked clinical effects including: oedema volume reduction, limb function improvement, decreasing physical symptoms. There are numerous assessment methods available, which creates difficulties in relative evaluation / meta-analyses (eg. among different therapeutical schools). Basic method of evaluation involves comparing affected limb volume or oedema volume (i.e. the difference in limb volumes between the affected and unaffected side) calculated from circumference measurements, before and after physical treatment. Relating limb volume or edema volume to normal limb volume allows us to compare patients with lymphoedema who are constitutionally different. Apart from limb volumes assessment, evaluation of oedema consistency is also important (pitting edema vs. non-pitting edema on palpation), which provides an information about disease progression. Other methods of assessment involve comparison of limb function – joint mobility defect, gripping force and evaluation of disturbances of hand manipulation and walking. Yet, another method of evaluation involves comparison of physical disorders associated with lymphoedema (usually limb pain, heaviness and weakness) and the healthrelated quality of life. Lymphoscintigraphy seems to be an objective method of evaluating lymphatic transport and the morphology of lymph distribution. Both dynamic and static scintigraphy are useful for assessing spontaneous lymph outflow from the affected limb before and after physiotherapy. In this article, methods of evaluating the efficiency of lymphoedema treatment are discussed, and a practical approach to lymphoedema management is proposed.
Authors and Affiliations
Katarzyna Ochałek, Tomasz Grądalski, Iwona Dziura
Keywords
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