Pneumatic Compression Improves Quality of Life in Patients with Lower-Extremity Lymphedema

Blumberg, Sheila; Berland, Todd; Rockman, Caron; Mussa, Firas F.; Brooks, Allison; Cayne, Neal S.; Maldonado, Thomas S.

doi:10.1016/j.avsg.2015.07.004

Cited by 38 publications

(28 citation statements)

References 19 publications

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“…These results suggest that, if lymph stasis is prevented (by compression garments, massage, PCT, or a combination thereof), fat re-accumulation and limb volume increases can be minimized. Consistent with this idea, a number of studies have found that intermittent pneumatic compression (IPC, another term for PCT) benefits LE patients [45], reduced LE swelling, skin fibrosis, and pain in 90% of PCT patients [46], improved quality of life [47], and that advanced PCT decreased total per-patient costs by 31% in 12 months post-device [48]. It is possible that PCT used after lymphaticovenous anastomoses and lymph node transfer surgeries could speed recovery and improve outcomes by directing lymph-to-venous flow of anastomoses [49].…”

Section: Discussionmentioning

confidence: 99%

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

Aldrich

Gross²,

Morrow

et al. 2017

J. Innov. Opt. Health Sci.

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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.

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Section: Discussionmentioning

confidence: 99%

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

Aldrich

Gross²,

Morrow

et al. 2017

J. Innov. Opt. Health Sci.

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“…The Flexitouch System consists of a controller that provides segmental, calibrated, gradient pneumatic compression (US HCPCS code E0652) paired with inflatable garments. This device has been used to effectively treat limb lymphedema . Garments were specifically designed to permit treatment of head and neck lymphedema.…”

Section: Methodsmentioning

confidence: 99%

“…This device has been used to effectively treat limb lymphedema. [15][16][17][18][19] Garments were specifically designed to permit treatment of head and neck lymphedema. The head and neck garments are constructed of nylon with a total of 14 pneumatic chambers covering part of the head, neck, and chest, as illustrated in Figure 1.…”

Section: Treatment Device and Proceduresmentioning

confidence: 99%

Usability of advanced pneumatic compression to treat cancer‐related head and neck lymphedema: A feasibility study

2017

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BackgroundThis functional usability study assessed ease of use, fit, comfort, and potential clinical benefits of advanced pneumatic compression treatment of cancer‐related head and neck lymphedema.MethodsPatient‐reported comfort and other treatment aspects were evaluated and multiple face and neck measurements were obtained on 44 patients with head and neck lymphedema before and after 1 treatment session to assess usability and treatment‐related lymphedema changes.ResultsA majority of the patients (82%) reported the treatment was comfortable; most patients (61%) reported feeling better after treatment, and 93% reported that they would be likely to use this therapy at home. One treatment produced overall small but highly statistically significant reductions in composite metrics (mean ± SD) of the face (82.5 ± 4.3 cm vs 80.9 ± 4.1 cm; P < .001) and neck (120.4 ± 12.2 cm vs 119.2 ± 12.1 cm; P < .001) with no adverse events.ConclusionResults found the treatment to be safe, easy to use, and well tolerated while demonstrating edema reduction after a single initial treatment.

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“…Previous reports have indicated symptom relief, improvement in control of edema and in QoL in patients with lower extremity lymphedema. [53] It has been shown to be less effective in patients with increased subcutaneous fibrosis, leading to poor tissue compliance. The 2013 Consensus document of the ISL supports the use of intermittent pneumatic compression as an adjunct modality [11] and systematic reviews have suggested that PCP may provide an acceptable home-based treatment modality in selected patients, in addition to wearing compression garments.…”

Section: Compression Garmentsmentioning

confidence: 99%

“…Devices that produce excessive pressure to the skin surface may be harmful on superficial lymphatic structure and, therefore, multi-chamber devices with trunk apparatus are recommended to avoid genital and trunk lymphedema. [53,55] physiCal thErapy modalitiEs laser Low-level laser therapy (LLLT) has been suggested as a useful treatment for lymphedema. It promotes lymphangiogenesis and stimulates lymphatic motility with no significant changes in the tissue architecture.…”

Section: Compression Garmentsmentioning

confidence: 99%

Lymphedema diagnosis, treatment, and follow-up from the view point of physical medicine and rehabilitation specialists

Borman

2018

Turk J Phys Med Rehab

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Lymphedema is an incurable, debilitating and progressive condition, leading to physical and psychosocial consequences for the patients, if left untreated. The Physical Medicine and Rehabilitation (PMR) specialist is responsible for the differential diagnosis and evaluation of the patient to tailor management and rehabilitation strategies. Therefore, the PMR specialist must have knowledge and education on the diagnosis of disease and possible complications as well as evaluation, treatment and follow-up of the patient. In this review, the pathophysiology, epidemiology, and diagnostic and therapeutic approaches of lymphedema as well as preventive strategies and follow-up strategies are discussed in the light of the current literature.

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Pneumatic Compression Improves Quality of Life in Patients with Lower-Extremity Lymphedema

Cited by 38 publications

References 19 publications

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

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

Usability of advanced pneumatic compression to treat cancer‐related head and neck lymphedema: A feasibility study

Lymphedema diagnosis, treatment, and follow-up from the view point of physical medicine and rehabilitation specialists

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