Introduction:
An interruption in the movement of lymph fluid through the lymphatic system causes lymphedema, which causes swelling in the arms or legs. Fluid builds up under the skin as a result of this disruption. Lymph node excision is the most frequent cause of lymphedema. It may also be brought on by a restriction that prevents the flow of lymph fluid. Lymphedema affects about one in five women who have had lymph nodes in their underarms removed as part of their breast cancer therapy and are now battling or have already overcome breast cancer.
Lymphedema usually appears for three months to 20 years following cancer treatment. Early lymphedema detection and treatment might lead to quicker and better results. Nevertheless, medication given later in the disease's chronic stages may be helpful. Physical therapists collaborate closely to control lymphedema-related swelling and achieve the goals of returning to regular daily tasks.
How Does Physical Therapy Help?
Physical therapists play a crucial role on the medical team by collaborating closely with patients to develop a plan of care that will reduce swelling and help them get back to their normal activities.
Compression clothing, physical activity, and elevating the affected limb to promote lymph flow can frequently help treat lymphedema in its early stages when the swelling is minimal. The physical therapist could apply a "complete decongestive therapy" for cases of more acute edema. Manual lymphatic drainage, which has a gentle massage-like sensation and aids in improving lymphatic flow from the arm or leg, is frequently used as the initial step. After that, compression bandaging is applied to help with edema reduction. The therapists closely monitor the size of the limb throughout therapy sessions.
Once the limb has decreased to the desired size, the physical therapist will help the patient begin to take over his or her care by:
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Establish a sound workout regimen to improve the physical fitness without excessively straining the injured arm or leg.
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Adapting compression garments to guarantee optimal fit and collaborating with patients to choose the optimum type of garment for their needs.
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Providing the patient with information on healthy eating to prevent fluid retention in the tissues and skin care to lower the chance of infection.
What Is Complete Decongestive Therapy?
According to the international recommendations of the International Society of Lymphology, CDT (complete decongestive therapy) is the best worldwide treatment for lymphedema and the gold standard treatment. Numerous studies have shown how successfully CDT reduces the swelling and pain associated with lymphedema.
In the past, it was a rigorous program that combined the following four types of therapy: manual lymphatic drainage, compression bandaging, skin care, and exercise. CDT takes a more all-encompassing approach to caring for persons with lymphedema by including self-care and additional biopsychosocial support services when required, such as dietary support, psychiatric counseling, etc. CDT is a procedure that was first used in Europe and Australia but is now spreading to the US.
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Can successfully reduce lymphedema volume.
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Increase range of motion (ROM) and mobility.
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Improve living quality.
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Reduce the chance of cellulitis.
CDT consists of two parts.
Phase I (the intensive phase) involves mobilizing fluid and reducing the growing connective tissue. Patients are strongly advised to receive treatment at least five times a week, once a session per day for a few weeks, to achieve the most effective benefits.
Phase II (maintenance phase) attempts to maximize connective tissue reduction while maintaining the edema reduction.
What Are the Self-Care Management Techniques Involved?
The importance of "self-care" education, or whatever the client does at home to lower the likelihood that the lymphedema may return or worsen in the future, is necessary.
Lymphedema therapists should teach lymphedema patients how to
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Put on their compression sleeves and clothing and take care of it. Patients must know that regular garment replacement is required to maintain adequate compression. Every garment should be washed daily to maintain compression and changed after 3 to 6 months of regular usage. However, particularly active patients might need to do so faster.
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Preventing cuts, injuries, overuse, severe temperatures, and other events that could promote the release of lymph, which subsequently increases the risk of lymphedema on an arm, hand, chest, or in any other body area.
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Inform individuals about the warning signs and symptoms of an infection, which are important for those with lymphedema.
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Aid in creating a customized workout and/or weight-control strategy for each person.
Educate patients on performing manual lymphatic drainage on their bodies at home. if the client can manage the technique and "self-MLD" is suitable. Remind the client that going above what is advised or using more forceful massage strokes for MLD could have negative effects.
What Type of Physical Therapist Is Needed?
Even though all physical therapists are trained to treat a range of illnesses, including lymphedema, one might want to take the following into account:
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A physical therapist with expertise in lymphedema care.
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A physical therapist with specialized training in lymphedema therapy and possesses advanced knowledge, expertise, and abilities relevant to the disease.
Tips for choosing a physical therapist (or some other kind of healthcare professional):
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Find a skilled physical therapist to treat lymphedema by asking for referrals from family, friends, or other medical professionals.
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When making an appointment, ask a physical therapist about their expertise in treating lymphedema patients.
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Prepare to describe the symptoms as thoroughly as possible and what makes them worse.
Conclusion:
Complex decongestive therapy (CDT) seeks to permanently regulate the volumetric and metaplastic tissue alterations brought on by lymphedema. CDT is undoubtedly advantageous, as numerous studies have demonstrated. CDT accomplishes and continues to achieve limb volume reductions of 50 to 70% when performed by highly skilled therapists. Electrostimulation, acupuncture, Kinesio taping, deep oscillation, low-level laser therapy, and ultrasound are a few other lymphedema treatment options. However, there needs to be more data to support their use. It is not advised to use pharmaceutical treatments to treat lymphedema, such as diuretics and benzopyrones.
