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Lymphatic Management - Your reliable and effective choice

By Balanced Physical Therapy | September 1, 2008

Balanced PT distributed this article to area doctors on July 22, 2008.

Certified Lymphedema TherapistFor years, Balanced Physical Therapy has managed cases of swelling and lymphedema reliably and effectively.  Balanced Physical Therapy has served this community for almost a decade.  We put at your disposal more than a century of combined physical therapy experience, and our team includes a physical therapist certified by the Lymphology Association of North America (LANA).  Balanced Physical Therapy stands ready to help your patients manage swelling to prevent lymphedema and to help patients manage lymphedema when it does occur. 

Recommended Frequency, Duration, and Therapist Training:
A simple course of two visits plus education and home exercise may be all that is necessary to prevent simple swelling from becoming lymphedema.  For management of existing lymphedema, the research based position statement of the National Lymphedema Network states, “Optimally, CDT is performed until the reduction of fluid volume has plateaued, often after 3 to 8 weeks. . . At present, it is unclear to what degree deviation from the intensive and integrated approach that is the hallmark of CDT (Complete Decongestive Therapy), will compromise lymphedema treatment outcomes.”  The National Lymphedema Network position statement also states: “Therapists providing CDT should have completed at least 135 hours of training as recommended by the Lymphology Association of North America.”  If lymphatic management treatment plans have reduced frequency, fewer elements, or lesser-credentialed professionals compared to that called for by the nationally recognized recommendations, both the patient and the treating physician should fully understand the rationale for delivering lesser care.  The Lymphatic Management Program at Balanced Physical Therapy fully complies with current, research-based recommendations for intensive frequency, program elements, and therapist training.  A licensed physical therapist certified by LANA designs all treatment plans and delivers all the hands-on lymphatic treatments.  Our Lymphatic Management Program includes manual lymphatic drainage, compression therapy, compression garments, remedial exercises, home exercise training, and lifestyle fitness training.

Research:
Large case series on complete decongestive therapy demonstrate limb volume reductions of 50-70%, enhanced cosmesis, and reduced incidence of cellulitis.1-4  Research involving lymphoscintigraphies has demonstrated that manual lymphatic drainage stimulates accessory routes useful for resorption of lymph.5  Numerous studies have demonstrated the safe efficacy of complete decongestive therapy1-4 (which involves compression garments) and of manual lymphatic drainage alone6-10 (without compression garments). 

Delivering Personal and Professional Experience:
Val Collins earned her physical therapy degree at the University of Connecticut in 1983.  Soon after moving to Chapel Hill in 1995, she began experiencing swelling and pain in her foot and leg.  While the problem proved life limiting in many ways, the inability to get a clear diagnosis or an effective treatment proved frustrating.  It seems that the combination of a bug bite and a transatlantic flight triggered lymphedema in her leg.  After ten years of not giving up, Val finally received Manual Lymphatic Drainage.  Val was so impressed by the therapy’s ability to resolve her symptoms and by the growing body of research on lymphatic drainage that she completed formal training to become LANA certified.  Now, Val Collins, PT works as part of the Balanced Physical Therapy team to improve the lives of your patients.

Please let your patients know that Balanced Physical Therapy serves as a reliable and effective choice for Lymphatic Management Programs.

REFERENCES

  1. Cheville A, McGarvey C, Petrek J. et al. “Lymphedema management.” Semin Radiat Oncol. 2003; 12 (3): 290-301.
  2. Fiaschi E, Francesconi G, Fiumicelli S. “Manual lymphatic drainage for chronic post-mastectomy lymphodema treatment.” Panminerva Med. 1998; 40 (1): 48-50.
  3. Liao S, Huang M, Chou Y. “Successful complex decongestive physiotherapy for lymphedema and lymphocutaneous reflux of the female external genitalia after radiation therapy.” J Formos Med Assoc. 2003; 102(6): 404-6.
  4. Leduc O, Leduc A, Bourgeois P. “ The physical treatment of upper limb edema.” Cancer. 1998; 83 (12 Suppl American): 2835-9.
  5. Ferrandez J, Laroche J, Serin D, et al. “Lymphoscintigraphic aspects of the effects of manual lymphatic drainage.” J Mal Vasc. 1996; 21 (5): 283-9.
  6. Kafejian-Haddad A, Perez J, Castiglioni M, et al. “Lymphscintigraphic evaluation of manual lymphatic drainage for lower extremity lymphedema.” Lymphology. 2006; 39 (1): 41-8.
  7. Williams A, Vadgama A, Franks P. “A randomized controlled crossover study of manual lymphatic drainage therapy in women with breast cancer-related lymphoedema.” Eur J Cancer Care (Engl). 2002; 11 (4): 254-61.
  8. Kligman L, Wong R, Johnston M, et al. “The treatment of lymphedema related to breast cancer: a systematic review and evidence summary.” Support Care Cancer. 2004; 12 (6): 421-31.
  9. de Godoy J, Batigalia F, Godoy F. “Preliminary evaluation of a new, more simplified physiotherapy technique for lymphatic drainage.” Lymphology. 2002; 35(2): 91-3.
  10. Herpertz U. “Outcome of various inpatient lymph drainage procedures.” Z Lymphol. 1996; 20 (1): 27-30.

©BMA 2008