More specifically, concerning the lymphedema in the upper limb, 9. Respectively, about the lymphedema in the lower limb, 4. As regards the duration of lymphedema, The severity of lymphedema was classified according to the instructions of the International Society of Lymphology ISL [ 11 ].
The median value of PEV in the upper and lower limbs, prior to treatment, was Therefore, according to the ISL classification, patients with upper limb lymphedema had marginal severe lymphedema while patients with lower limb lymphedema had moderate lymphedema.
Initial measurement is the first-baseline measurement pre-treatment value and last measurement is the fourth measurement post-treatment value. For patients with upper limb lymphedema, the variable EV decreased significantly from the initial measurement with a median of In the third measurement, it also decreased significantly with a median of Concerning the PEV variable, it decreased significantly from the initial measurement with a median of In the third measurement, it did not change significantly with a median value of For patients with lower limb lymphedema, the EV variable was also significantly reduced from initial measurement with a median of At the subsequent measurements, it remained at similar levels, with median values for the third and last measurement Concerning the PEV variable, it decreased significantly from the initial measurement, with a median of In the third measurement, it did not change significantly, with a median value of This rate was similar for both categories of patients, with a median value of Concerning the safety of CDT in phase I, we did not record any infection, trauma, or pain during the treatment.
Moreover, we did not record complaints from the patients concerning the treatment of CDT. Lymphedema is a significant chronic issue not only for the patients themselves but also for the medical community worldwide. The results of the present study have shown that phase I of CDT is an effective therapeutic method that has a great positive effect on lymphedema reduction. The percent of edema reduction in Greek patients for both the upper and lower limbs was quite high In a prior study of patients with upper or lower limb lymphedema, primary and secondary type, where CDT was applied for about In a relevant study conducted by Yamamoto, CDT was applied in 82 women for a median duration of six and 10 days for upper or lower limb lymphedema.
Results showed a Morgan et al. But in this prospective study of therapeutic responses in chronic lymphedema, phase I of CDT was combined with patient instruction in self-care self-massage and self-bandaging. The mean initial lymphedema volume was ml and after eight weeks two sessions per week of intervention, it was ml and the edema decreased by Phase I of CDT again was combined with instruction in self-care [ 27 ].
Even if the greater part of the reduction of the volume of the lymphedema happens in the first five days of treatment, according to Leduc O, Leduc A, Bourgeois, and Belgrado , after that, another reduction will be achieved but it will be less than the first. However, it should be noted that patients in this study were only studied for the first two weeks of treatment [ 28 ].
Again, in this study, the study time of the population was limited. In our study, the greatest reduction was achieved as expected at the second measurement with the decrease continuing but to a lesser extent until the end of the treatment [ 29 ]. There was a tendency for people with a longer duration of lymphedema and a higher degree of fibrosis to receive more sessions. However, Yamamoto R and Yamamoto T, , found that there is no correlation between the duration of lymphedema and the duration of phase I CDT [ 25 ].
Furthermore, Liao et al. The effectiveness of the intervention of CDT of phase I varies in different studies and the wide range in terms of dosage minutes of the session, number of sessions per week, and number of weeks , which observed among the researchers and the lack of comparison among these studies indicate the need to develop a common protocol of treatment for better provision of services.
More research is, therefore, needed to identify the factors affecting the effectiveness of CDT in phase I. Perhaps the use of the same protocol of treatment worldwide could be useful for the therapists and beneficial for the patients. Concerning the safety of CDT in phase I, we had not any remarkable problem in patients of our study.
We did not record any redness, pain, infection, or trauma or any complaint from the lymphedema patients, during the treatment. Prerequisites of successful treatment of CDT are the availability of physicians i. Any infection or trauma could stop the treatment of CDT. It is important for the therapist to follow the correct treatment of CDT in order to achieve greater success in treatment without local complications.
This study has some limitations. The sample is not representative of patients with lymphedema living in Greece. Moreover, perhaps the absence of a control group with a different treatment of CDT could give us more information, although our study treatment showed a great reduction of edema and safety.
Conclusively, the treatment of lymphedema with CDT phase I showed positive safety and great effectiveness on the treatment of lymphedematous limbs in the population of the present study.
Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Skin Care — The purpose is to inspect skin, provide moisture, and prevent infection. Compression Therapy — This involves wearing compression garments to keep swelling from returning. Exercise — This includes doing specific exercises to do to help push fluid up and out of your limb.
Skin Care — The purpose is to keep skin moisturized to avoid cracking. Exercise with Lymphedema. Self-management for Lymphedema. Surgeries for Lymphedema. Finding the Right Professional Support. Starting program Subscribe to our starting program. Community Share stories and experiences. Find a healthcare professional Get help finding the right expert. Help and Support. If you have questions about referring a patient or making an appointment, please call To reach our certified lymphedema therapists, please email PTOTlymphedema email.
Primary lymphedema occurs when a child is born with a poorly working lymphatic system i. Symptoms may be present at birth or can present when the child is older. Secondary lymphedema occurs as a result of damage to the lymph nodes or lymph vessels.
Damage may be caused by trauma, surgery or radiation during cancer treatment. Manual lymphatic drainage MLD is a gentle stretching technique that improves the function of the lymphatic system by rerouting lymphatic fluid around blocked areas of the body. If your child is treated at CHOP, a physical or occupational therapist will order compression garments to fit your child as part of complete decongestive therapy.
These garments are custom-made for each child, with the specific size and needs of your child in mind.
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