Szuba A, Cooke JP, Yousuf, Rockson SG.
Decongestive lymphatic therapy for patients with cancer-related or primary
lymphedema.
Am J Med 2000 Sep;109(4):296-300

Stanford Lymphedema Center, Division of Cardiovascular Medicine, Stanford
University School of Medicine, Stanford, California, USA.

PURPOSE: A prospective evaluation was undertaken to assess the efficacy of
intensive, short-term decongestive lymphatic therapy coupled with focused patient
instruction in long-term self-care for the management of lymphedema. METHODS: The
therapeutic responses of 79 patients with lymphedema were analyzed prospectively.
Each patient received intensive, short-term decongestive lymphatic therapy, with
quantification of the extent and durability of the clinical response.
Decongestive lymphatic therapy was performed by therapists trained in these
techniques. The mean (+/-SD) duration of therapy was 8+/-3 days. Instruction in
self-management techniques was incorporated into the therapeutic regimen by day 3
of the patient's treatment. The mean period of follow-up was 38+/-52 days.
Changes in the volume of the affected limb were assessed with a geometric
approximation derived from serial measurements of circumference along the axis of
the limb. RESULTS: The mean short-term reduction in limb volume was 44%+/-62% of
the excess volume in the upper extremities and 42%+/-40% in the lower
extremities. At follow-up, these results were adequately sustained: mean
long-term excess volume reductions of 38%+/-56% (upper extremities) and 41%+/-27%
(lower extremities) were observed. CONCLUSION: Decongestive lymphatic therapy,
combined with long-term self-management, is efficacious in treating patients with
lymphedema of the extremity.