Akademik Veri Yönetim Sistemi
47th Congress of European Society of Lymphology, İstanbul, Türkiye, 30 Mayıs - 01 Haziran 2024, ss.18, (Özet Bildiri)
Objectives:
The
objective of this study is to demonstrate the applicability of digital physiotherapy
in treating unilateral and bilateral lower extremity lymphedema (LEL). The
study aimed to examine the effect of digital physiotherapy on extremity volumes
in patients with lower extremity lymphedema after a 4-week treatment and a
12-week follow-up.
Background:
Lower
extremity lymphedema may arise as either a primary or secondary condition. Combined
decongestive therapy is the gold standard treatment for lymphedema, known for
its effectiveness in both short and long-terms. Digital physiotherapy for
lymphedema patients is a modified form of combined decongestive therapy with
the help of technology. Digital physiotherapy represents a modern approach that
can promote treatment adherence and consistency.
Methods:
The
study included patients with unilateral and bilateral lower extremity
lymphedema who were admitted to the outpatient clinic. The circumferences of
the extremities were measured from the first metatarsophalangeal joint to the
proximal with 4-cm intervals for each. Circumference measurements were taken pre-treatment
(V0), post-treatment (V1), and follow-up (V2). During the initial session,
which was conducted face-to-face, patients received basic introduction to skin
care and risk reduction training. A trained physiotherapist demonstrated the
self-bandaging and self-manual lymphatic drainage techniques while the
caregiver videotaped it. Patients learned gluteal sets, knee sets, toe
flexion-extension and breathing exercises and received booklets with
instructions. After the first session, treatment was provided remotely for 4-weeks
using digital telecommunication technologies. After 4-weeks of treatment,
self-bandaging was replaced by compression stocking and patients were followed
for 12-weeks.
Results:
The
study involved 82 (n=129 legs) patients with lower extremity lymphedema, with a
mean age of 56.53±18.36 years (63 female/19 male, 47 bilateral/35 unilateral LEL,
37 primary/45 secondary LEL). The mean extremity volume of the patients in the
pre-treatment evaluation was 5027.71±1826.05 mL. After 4-weeks of digital
physiotherapy, mean extremity volume of the patients was 4682.31±1746.05 mL. Digital
physiotherapy showed significant positive changes in lower extremity lymphedema
patients (V0-V1=345.40±762.03 mL; p<0.001). The mean extremity volume at
12-week follow-up was 4310.52±1380.24 mL. In the long-term, digital
physiotherapy continued to demonstrate significant positive
effects in patients with lower extremity lymphedema (V1-V2=371.79±648.66 mL; p<0.001).
Conclusions:
Our
study found that the application of combined decongestive therapy as a digital
physiotherapy method was effective for extremity volume reduction in lower
extremity lymphedema patients. This approach has demonstrated both short-term
and long-term efficacy for patients with lower extremity lymphedema. Therefore,
digital physiotherapy offers lower extremity lymphedema patients an alternative
method to combined decongestive therapy.
Keywords:
lower
extremity lymphedema, combined decongestive therapy, digital physiotherapy, self-management