3. INTRODUCTION
Physical therapy for Lymphedema
An abnormal accumulation of protein-rich fluid in the interstitium,
causing chronic inflammation and reactive fibrosis of the affected
tissues
Usually in an extremity, but can also occur in the head, neck, genitals,
and abdomen
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Definition
4. Treatment Options
Physical therapy for Lymphedema 4
Pneumatic
compressio
n pump
Complete
decongestive
therapy
(CDT)
Elastic
support
garments
Surgery
5. Advantages
Physical therapy for Lymphedema 5
Can be used at home by patients
Fast application
Disadvantages
Disregards the fact that the ipsilateral can be
LE edema, the pump can cause genital edema:
UE causebreast edema
extended use can cause additional fibrosis
many hours a day with elevated
6. Complete decongestive therapy (CDT)
MLD
Compression bandaging
Exercise
Skin and nail care
Instructions inself care
7. a gentle manual treatment
which improves the
activity of the lymph vascular
system.
it reroutes the lymph flow around
blocked areas into centrally
located healthy areas which then
can drain into the venous system.
Manual Lymph Drainage
8. Compression bandaging
Physical therapy for Lymphedema 8
Short stretch bandages are applied
to increase the tissue pressure
in the edematous extremity.
● Prevents re-accumulation of
lymph fluid
● Helps break down fibrous
connective tissue that has
developed
9. Exercise
Performed with the bandages on or while wearing a compression garment.
Active ROM, stretching, strengthening
Low exertion
Diaphragmatic breathing
• Increase muscle and joint pumping
• Increase lymph vessel activity
• Increase venous and lymphatic return
10. Skin and Nail Care
Physical therapy for Lymphedema 10
nail care Infection prevention Skin Care
Cut nails straight across. Ing
rown nails cellulitis
should receive expert attention
avoiding injury, cleaning all
injuries immediately, calling
MD at first sign of infection.
Eliminate bacteria and fungal
growth by using medicated
powders
11. Physical therapy for Lymphedema
• Self-bandaging
• Self-MLD as needed
• Exercise
• Donning and doffing compression garment
• Regular follow-up visits
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Self Care
12. Complete decongestive therapy
is a Two-Phase Therapy
Physical therapy for Lymphedema 12
Treatment Phase Meticulous skin/nail care
Manual Lymph Drainage
Compression bandaging
Self care education
Exerciselasts as long as necessary
MaintenancePhase
lifelong maintenance
Compression garments during the day
Bandages at night
Skin and nail care
Daily exercise
Manual Lymph Drainage as needed
Regular follow-up visits
14. Malignant lymphedema
Insufficient treatment (only used MLD or improper
bandaging)
Deviation from CDT protocol
Associated illnesses
Lack of compliance
Active cancer
Faulty diagnosis
When does CDT fail?
15. Compression
garments
Elastic garments are uncomfortable and ineffective if
worn while the limb is edematous.
Garments do nothing to correctthe underlying cause
of the edema.
Garments are needed afterthe Treatment Phase
to prevent refill.
16. Surgery
Physical therapy for Lymphedema 16
● Microsurgical
techniques
● Liposuction
● Debulking/Reduct
ion procedures