STUDY OF EDEMA REDUCTION PATTERNS DURING THE TREATMENT PHASE OF COMPLEX DECONGESTIVE PHYSIOTHERAPY FOR EXTREMITY LYMPHEDEMA

Abstract

Shortening the treatment phase ofcomplex decongestive physiotherapy (CDP)is extremely important both for individualpatients and medical economics. In 83patients with stage II unilateral secondaryextremity lymphedema (31 upper extremitiesand 52 lower extremities), the daily changesin the volume of affected extremities duringthe treatment phase of CDP were prospectivelyinvestigated. For the upper extremitylymphedemas, the biggest change was seenbetween days 1 (100% residual edema rate)and 2 (46.0 ± 2.7%; mean ± SD) of therapywith a 54.0% reduction (p<0.0001). Betweendays 2 and 3 (38.0 ± 2.6%) of therapy, therewas an 8.0% reduction (p<0.05). From days3 to 6 of therapy, slight changes ranging from0.2 to 3.2%/day were seen. For the lowerextremity lymphedemas, the biggest changewas seen between days 1 (100%) and 2 (44.5±2.1%) of therapy with a 55.5% reduction(p<0.0001). Between days 2 and 3 (33.5 ±2.6%) of therapy, there was an 11.0% reduction(p<0.001). The daily volume changesfrom days 4 to 6 were slight, ranging from0.1 to 1.0%/day. During the treatment phaseof CDP, the largest volume changes wereseen soon after the start of therapy.