Impact of Aggressive Decongestion on the Maintenance Phase in Combined Physical Therapy for Lower Extremity Lymphedema

Abstract

OBJECTIVES: To evaluate the impact of initial aggressive decongestion (Phase 1) on the maintenance phase of complex physical therapy (CPT).MATERIALS AND METHODS: We reviewed 27 patients with unilateral and 3 patients with bilateral lower extremity lymphedema who started CPT between April, 2009 and October, 2010. Twelve patients elected to undergo in-hospital Phase 1 (Group I), while the other 18 started CPT on an outpatient-basis without having Phase 1 (Group O). The extremity volume was assessed at the beginning of CPT, and then 3 and 6 months later.RESULTS: A significant reduction in extremity volume was achieved in each group after 6 months of CPT: from 9049 ± 1912 mL at the beginning to 7771 ± 1486 mL (p = 0.0033) in group I; and from 7370 ± 1392 mL to 7036 ± 1241 mL (p = 0.0200) in group O. However, after 6 months, extremity volume reduction (-845 ± 1283 mL in group I vs. -404 ± 370 mL in group O; p = 0.7672) and volume reduction rates (-23.6 ± 22.7% in group I vs. -46.4 ± 52.2% in group O; p = 0.2564) did not differ significantly between the groups.CONCLUSION: Phase 1 did not have a significant impact on the maintenance phase in terms of control of the extremity volume for at least 6 months after the induction of CPT.