lymphedema : overview and treatment considerations
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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 - PowerPoint PPT PresentationTRANSCRIPT
Linda Koehler, PT, CLT-LANAUniversity of Minnesota
Artery VeinLymphatics
Blood Capillary
Arterial malformation •Venous malformation•Venous insufficiency•DVT
•Lymphatic malformation•Infection•Trauma•Phlebolymphedema
Venous swelling
Lymphatic swelling
The Lymphatic System
Main functions: Helps balance the
body’s fluidProtects the body from
infection
Wikipedia-Lymphatic system, July 2008
What is Lymphedema?Swelling caused by an abnormal
accumulation of protein rich fluidIt can be located anywhere in the body -arms,
legs, trunk, chest, genitalia, or head/neckIt is chronic and progressive if left untreatedLeads to increase swelling, loss of function,
chronic infections, skin changes, and interferes with wound healing
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
Lymphedema Treatment: Complete Decongestive TherapyFour treatment
components:Manual Lymph
DrainageCompression TherapyRemedial exercisesSkin and nail careWound 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
Complete Decongestive Therapy
Manual Lymph Drainage-Manual movement of lymphatic fluid to areas that are functioning normal
Complete Decongestive TherapyCompression 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!Juzo
BSN Jobst
Complete Decongestive TherapyLymphatic 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
Complete Decongestive TherapyProper skin and nail care /Lymphedema
precautionsAvoid infectionsAvoid extreme hot and cold temperaturesAvoid constriction Take good care of your skinLive a healthy lifestyle
Complete Decongestive TherapyWound Care
Pulsatile lavage with suctionDebridementVACCMIST therapyDressing changes and drainage management Wound prevention and protection.
Physical Therapy InterventionsPain 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
**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.
How to find a CERTIFIED LYMPHEDEMA THERAPIST:
Academy of Lymphatic Studies- www.acols.comKlose Training- www.klosetraining.comNorton School- www.nortonschool.comVodder School- www.vodderschool.comNational Lymphedema Network-
www.lymphnet.orgLymphology Association of North America-
www.clt-lana.orgCasley-Smith Training- [email protected]
Inpatient Lymphedema Program: Providence St. Peter Hospital -Olympia,
Washington-1-888-492-9480 x 37646
Genital compression
Scrotal swell spotLabia swell spot