Effect of pneumatic compression therapy on lymph movement in lymphedema-affected extremities, as assessed by near-infrared fluorescence lymphatic imaging

Abstract

Previous studies have shown cost effectiveness and quality-of-life benefit of pneumatic compression therapy (PCT) for lymphedema. Insurers, such as the Centers for Medicare/Medicaid (CMS), however, desire visual proof that PCT moves lymph. Near-infrared fluorescence lymphatic imaging (NIRFLI) was used to visualize lymphatic anatomy and function in four subjects with primary and cancer treatment-related lymphedema (LE) of the lower extremities before, during, and after pneumatic compression therapy (PCT). Optically transparent and windowed PCT garments allowed visualization of lymph movement during single, one-hour PCT treatment sessions. Visualization revealed significant extravascular and lymphatic vascular movement of intradermally injected dye in all subjects. In one subject with sufficient patent lymphatic vessels to allow quantification of lymph pumping velocities and frequencies, these values were significantly increased during and after PCT as compared to pre-treatment values. Lymphatic contractile activity in patent lymphatic vessels occurred in concert with the sequential cycling of PCT. Direct visualization revealed increased lymphatic function, during and after PCT therapy, in all lymphedema-affected extremities. Further studies are warranted to assess the effects of PCT pressure and sequences on lymph uptake and movement.

The effectiveness of two individualized physical interventions on the upper limb condition after radical mastectomy

“…Abundant research [3,[5][6][7] indicates that women who undergo breast surgery, axillary radiotherapy, or chemotherapy are more likely to have higher risk of breast cancer-related lymphedema and impaired shoulder range of motion. The importance of the problem is underlined by the presence of numerous surgical methods [3,4] and conservative therapies [11][12][13][14][20][21][22][23][24][25][26] for overcoming upper extremity disorders in breast cancer survivors.…”

“…despite the achieved progress in the treatment of breast cancer-related lymphedema, the problem related to physical rehabilitation of the patients remains relevant. Some studies [24][25][26] have shown that pneumatic compression therapy and manual lymphatic drainage significantly reduce breast cancer-related lymphedema of the affected limb. in these studies, a rational combination of two treatments (decongestive therapy with compression pumping or manual lymphatic drainage with compression bandage) proved effective in reducing lymphedema and improving the range of motion.…”

“…The majority of women are treated with complex physiotherapy methods that prove effective. Many reports showed the effectiveness of acupuncture [12], lymphatic drainage [13], Pilates-based exercises [14][15][16], yoga exercises [17,18], Nordic walking [19], aquatic exercises [20][21][22][23], and pneumatic compression therapy [24][25][26] for the treatment and prevention of postoperative breast cancer-related lymphedema, and quality of life improvement in women.…”

Manual Lymphatic Drainage in Postoperative Abdominoplasty With Core Liposuction Patients

“…For example, the superficial lymphatic system can be damaged during liposuction by the cannula strokes when removing the adipose tissue. 3 The lymphatic system can be further damaged when the abdominal skin is elevated, which leads to a discontinuity in the lymphatic system, and by the low abdominal incision, which transects the lymphatic channels. 3 Without the lymphatic drainage system, excess fluid, known as lymphedema, results.…”

“…3 The lymphatic system can be further damaged when the abdominal skin is elevated, which leads to a discontinuity in the lymphatic system, and by the low abdominal incision, which transects the lymphatic channels. 3 Without the lymphatic drainage system, excess fluid, known as lymphedema, results. This excess in fluid increases the inflammatory response that the tissue is exposed to and can, in turn, lead to skin fibrosis, accumulation of adipose tissue, and further accumulation of fluid.…”