Comparison of efficacy of the intermittent pneumatic compression with a high- and low-pressure application in reducing the lower limbs phlebolymphedema

Abstract

IntroductionThe primary lymphedema and chronic venous insufficiency present an important medical problem, and effective physical therapeutic methods to treat this problem are still at the search phase. The aim of this study was to compare the efficacy of intermittent pneumatic compression (IPC) of a high- or low-pressure level in the treatment of primary phlebolymphedema of the lower limbs.MethodsThe study included 81 patients with chronic venous insufficiency and primary lymphedema of the lower limbs. Group A consisted of 28 patients who underwent a monthly antiedematous therapy including a manual lymphatic drainage, multilayer bandaging, and IPC with the output pressure of 120 mmHg. Group B consisted of 27 patients who underwent the same basic treatment as group A and IPC with the output pressure of 60 mmHg. Group C (control) consisted of 26 patients who underwent only a basic treatment – without IPC.ResultsAfter completion of the study, it was found that the greatest reduction of edema occurred in patients who underwent treatment with a pressure of 120 mmHg. The comparison of percentage reduction of edema showed a statistically significant advantage of the group A over groups B and C, both for the changes in the right (P=0.01) and the left limb (P=0.01). Results in patients undergoing intermittent compression of the lower pressure (60 mmHg) were similar to those obtained in the control group.ConclusionThe IPC with the pressure of 120 mmHg inside the chambers effectively helps to reduce a phlebolymphedema. Furthermore, it appears that the treatments with a pressure of 60 mmHg are ineffective and their application becomes useless only in the antiedematous therapy.

Intermittent pneumatic compression for prolonged standing workers with leg edema and pain

“…In patients with chronic venous edema, a dose-dependent relationship was reported between high pressure and leg edema [24] . However, when comparing groups receiving a high pressure intervention (120 mm Hg) and a low pressure intervention (60 mm Hg) as well as a control group without IPC among patients with chronic venous insufficiency and primary lymphedema, swelling was reduced most significantly in the high pressure group [25] . Furthermore, applying IPC at 100 to 120 mm Hg for 3 years in patients with stage II–III lymphedema in the lower limb did not lead to notable complications [26] .…”

“…[ 24 ] However, when comparing groups receiving a high pressure intervention (120 mm Hg) and a low pressure intervention (60 mm Hg) as well as a control group without IPC among patients with chronic venous insufficiency and primary lymphedema, swelling was reduced most significantly in the high pressure group. [ 25 ] Furthermore, applying IPC at 100 to 120 mm Hg for 3 years in patients with stage II–III lymphedema in the lower limb did not lead to notable complications. [ 26 ] In their 2013 study, Zaleska et al [ 27 ] reported that a high pressure of about 120 mm Hg and at least 50 seconds of compression are required to produce efficient tissue fluid pressure and generate proximal flow.…”

The clinical and economic impact of chronic venous insufficiency-associated lymphedema and the prevalence of persistent edema after venous intervention

“…25 The use of LED-specific treatment in these patients has been shown to be beneficial, with prior studies showing improvement in both patient symptoms and economic burden. 9,26 However, the delay in initiating LED-specific therapy after venous intervention seen in this study suggests that there may be under-recognition of coexisting lymphedema in CVI patients, and further studies are warranted to determine if there is underutilization of LED-specific treatment.…”

Home management of lower limb lymphoedema with an intermittent pneumatic compression device: a feasibility study

“…Multiple-chamber garments typically provide sequential compression in an ascending pattern up the limb. Pumps vary in timing cycles and amount of pressure produced, ranging from low-pressure, slow-inflation to high-pressure, rapid-inflation devices [6].…”

“…Research regarding the efficacy of IPC is limited. Whilst early studies suggested that MLD and IPC are equally as effective in reducing upper limb oedema [7], studies examining sequential IPC as a treatment for lower limb lymphoedema [1, 6, 8, 9] demonstrated a lack of consensus with regard to treatment parameters. Historically, IPC pumps have used sequential cycles to provide a peristaltic massaging effect along the limb towards its root.…”