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Lymphedema : Overview and Treatment Considerations

Lymphedema : Overview and Treatment Considerations. Linda Koehler, PT, CLT-LANA University of Minnesota. Vascular System Abnormalities. Vein. Artery. Lymphatics. Venous malformation Venous insufficiency DVT. Arterial malformation. Lymphatic malformation Infection Trauma

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Lymphedema : Overview and Treatment Considerations

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  1. Lymphedema : Overview and Treatment Considerations Linda Koehler, PT, CLT-LANA University of Minnesota

  2. Vascular System Abnormalities Vein Artery Lymphatics • Venous malformation • Venous insufficiency • DVT Arterial malformation • Lymphatic malformation • Infection • Trauma • Phlebolymphedema Venous swelling Blood Capillary Lymphatic swelling

  3. The Lymphatic System Main functions: • Helps balance the body’s fluid • Protects the body from infection Wikipedia-Lymphatic system, July 2008

  4. What is Lymphedema? • Swelling caused by an abnormal accumulation of protein rich fluid • It can be located anywhere in the body -arms, legs, trunk, chest, genitalia, or head/neck • It is chronic and progressive if left untreated • Leads to increase swelling, loss of function, chronic infections, skin changes, and interferes with wound healing

  5. Signs and Symptoms • Swelling of a body part • Heaviness, tightness, or fullness • Tingling sensation • Tight clothing or jewelry • Decreased flexibility of a limb • Feeling of achiness or the limb may tire more easily • Pain, burning, throbbing • Skin and tissue changes, discoloration

  6. Lymphedema Treatment: Complete Decongestive Therapy Four treatment components: • Manual Lymph Drainage • Compression Therapy • Remedial exercises • Skin and nail care • Wound Care • Intensive Phase: Attending PT appts 4-5x/wk for 3-6 weeks. Appts lasting 1-2 hours. • Home management phase: Instruction in a home lymphedema program

  7. Complete Decongestive Therapy • Manual Lymph Drainage-Manual movement of lymphatic fluid to areas that are functioning normal

  8. Complete Decongestive Therapy • Compression Therapy • Compression bandaging - low stretch bandages are applied to promote movement of the lymph fluid, soften hardened tissue, and prevent re-accumulation of fluid (Low stretch bandages vs. high stretch) • Compression garments-Comes in various styles, material, compression, and options. PROPER FIT IS IMPORTANT! BSN Jobst Juzo

  9. Complete Decongestive Therapy • Lymphatic Exercises • Remedial exercises-helps improve lymphatic flow in an area (muscle pump action) • Aerobic exercise-biking, walking, etc. • Pool therapy/Aquatics-compression and movement of the water promotes lymph movement

  10. Complete Decongestive Therapy • Proper skin and nail care /Lymphedema precautions • Avoid infections • Avoid extreme hot and cold temperatures • Avoid constriction • Take good care of your skin • Live a healthy lifestyle

  11. Complete Decongestive Therapy • Wound Care • Pulsatile lavage with suction • Debridement • VACC • MIST therapy • Dressing changes and drainage management • Wound prevention and protection.

  12. Physical Therapy Interventions • Pain Management • TENS-Transcutaneous electrical nerve stimulator • Modalities such as ultrasound, e-stim, hot and cold packs (if not contraindicated) • Pain relief exercises and activity (ie. Yoga, relaxation excercises) • Compression garments

  13. **Each individual is different and may respond differently to therapy. People have different types of bodies, different patterns of movement, different alignments, different habits, and different conditions. Physical therapists can assess each individual and attempt to correct improper habits, alignments , movement patterns, and the physical condition of an individual.

  14. How to find a CERTIFIED LYMPHEDEMA THERAPIST: • Academy of Lymphatic Studies-www.acols.com • Klose Training- www.klosetraining.com • Norton School- www.nortonschool.com • Vodder School- www.vodderschool.com • National Lymphedema Network-www.lymphnet.org • Lymphology Association of North America- www.clt-lana.org • Casley-Smith Training- cltcourses@cs.com Inpatient Lymphedema Program: • Providence St. Peter Hospital -Olympia, Washington-1-888-492-9480 x 37646

  15. Genital compression Scrotal swell spot Labia swell spot

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