Effective strategies for a confounding clinical problem.

Understanding the Sources of Lymphedema

Our Lymphedema Management Program can help patients proactively manage their condition. Appropriate patients may include:

  • Those with primary or secondary lymphedema of the upper/lower extremities
  • Those with edema due to surgery or venous issues
  • Post-Mastectomy patients with node dissection
  • Cancer patients whose treatment damaged lymph nodes

Our therapists perform an initial evaluation to determine current status and to establish goals for treatment. This process leads to a decision on the most appropriate combination of care options to meet these goals. Our treatment approach may include manual edema mobilization, self-manual lymphatic mobilization, vasopneumatic pumping, range of motion, strengthening exercises, fitting of compression garments and patient education to facilitate self-care and maintenance.

The overall goals of therapy are to decrease edema, restore range of motion, provide adequate mobility and strength to allow for appropriate functional activities, and to prepare the patient for the greatest possible level of independence.

Therapeutic exercise approaches include a combination of high repetition aerobic activity, which facilitates fluid drainage from the involved extremity, and focused muscle strengthening to enhance function. This “muscle pump” mechanism is also an essential part of the patient’s ongoing maintenance strategy.

Vasopneumatic Pumping

Sequential, gradient vasopneumatic pumping is a key component of our program, offering a safe, effective way to move and drain lymphatic fluid from the affected extremity. Carry-over to daily home pumping is a goal for effective self-management.

Compression Garments

In some cases, patients may be sent to a medical supply company to be fitted with an over-the-counter compression garment, or for a custom garment to better adapt to asymmetries. They are most easily applied following therapeutic measures which reduce the volume of fluid in the extremity.

Patient Education

Throughout the course of active therapy, the patient is being prepared to take on the responsibility for self-management. Key elements of patient education include:

  • Understanding the mechanisms of edema
  • Self-massage techniques for fluid reduction
  • Skin care to prevent infection
  • Compression garment use
  • Vasopneumatic pump use at home
  • Home range of motion and therapeutic exercise progression

For more information Lymphedema services, contact: Deb King, OTR/L, CHT (Belden Village 330-493-4210) or Thom Krupar, PT, Cert MDT (Alliance 330-829-2338).