CHANGES IN LYMPHATIC FUNCTION AFTER COMPLEX PHYSICAL THERAPY FOR LYMPHEDEMA

Abstract

Twenty-two extremities of 19 lymphedema patients (6 arms, 16 legs) were treated by 2weeks of complex physical therapy (CPT) and self home maintenance therapy (bandage/wearingof elastic garment and exercise). In addition to the clinical response of volume reduction beforeand 3 months after CPT, we analyzed the functional changes of the peripheral lymphatic systemby use of lymphoscintigraphy (LS).Before CPT, the main LS findings of lymphedema included dermal backflow (100%), absentor faintly visualized regional lymph nodes (95.5%), presence of collateral lymphatic vessels(68.2%), and no or barely visualized lymphatic vessels (27.3%). LS findings suggestingimproved lymphatic function after CPT were a decrease in dermal backflow (72.7%), an increasein radioisotope uptake by lymphatic vessels (27.3%), and an increase in radioisotope uptake bylymph nodes (9.1%). 81.8% of limbs showed improved lymphoscintigraphic findings and nochange in 9.1%. In the others (9.1%), LS findings appeared worse. There was, however, nocorrelation between LS “improvement” and the amount of limb volume reduction.