Abstract

Case Report

The efficacy of complex Decongestive Physiotherapy in patients with Bilateral Primary Lower Extremity Lymphedema and Untreatable multiple health conditions: A Case Report

Hümeyra Kiloatar PT*

Published: 08 September, 2017 | Volume 1 - Issue 3 | Pages: 093-098

Background: Primary lymphedema occurs as a result of genetic abnormalities of the lymph system. Currently, complex decongestive therapy is accepted as the standard treatment of the lymphedema. In this case presentation, we described the management of bilateral primary lower extremity lymphedema and the use of complex decongestive therapy.

Case Report: A 62 years old female patient had stage III primary lymphedema on her left lower extremity and stage II primary lymphedema on her right lower extremity. The patient, who had morbid obesity, also had untreatable sleep apnea, urinary incontinence, umbilical hernia and hypertension controlled by drugs. She had stage 4 gonarthrosis according to Kellgren – Lawrence classification in her both knees. The patient received complex decongestive therapy as an outpatient.

After 27 sessions of complex decongestive therapy, edema reduced in both lower extremities. Before the treatment started, the patient couldn’t go up and down stairs, get out and had difficulty mobility in the home. But after the treatment, the patient could go up and down 16 stairs by holding the railing, get out by two walking sticks and had less difficulty mobility in the home. However, due to gonarthrosis in her knees, her pain did not diminish.

Conclusion: Complex decongestive therapy is effective in the management of bilateral primary lower extremity lymphedema, which progressed with multiple health conditions.

Read Full Article HTML DOI: 10.29328/journal.jnpr.1001011 Cite this Article Read Full Article PDF

References

  1. Warren AG, Brorson H, Borud LJ, Slavin SA. Lymphedema: a comprehensive review. Ann Plast Surg. 2007; 59: 464-472. Ref.: https://goo.gl/pSGEyS
  2. Kerchner K, Fleischer A, Yosipovitch G. Lower extremity lymphedema: Update: Pathophysiology, diagnosis, and treatment guidelines. J Am Acad Dermatol. 2008; 59: 324-331. Ref.: https://goo.gl/Y99FWU
  3. International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: 2013 Consensus Document of the International Society of Lymphology. Lymphology. 2013; 46: 1-11. Ref.: https://goo.gl/Ey65To
  4. Gary DE. Lymphedema diagnosis and management. J Am Acad Nurse Pract. 2007; 19: 72-78. Ref.: https://goo.gl/r5M1hs
  5. Zuther J. Lymphedema management: The comprehensive guide for practitioners. Thime. 2009.
  6. Lawenda BD, Mondry TE, Johnstone PA. Lymphedema: a primer on the identification and management of a chronic condition in oncologic treatment. CA Cancer J Clin. 2009; 59: 8-24. Ref.: https://goo.gl/gU4pPZ
  7. Bogan LK, Powell JM, Dudgeon BJ. Experiences of living with non-cancer-related lymphedema: Implications for clinical practice. Qual Health Res. 2007; 17: 213-224. Ref.: https://goo.gl/HPK1n7
  8. Holtgrefe KM. Twice-weekly complete decongestive physical therapy in the management of secondary lymphedema of the lower extremities. Phys Ther. 2006; 86: 1128-1136. Ref.: https://goo.gl/p8Ue2y
  9. Bland KL, Perczyk R, Du W, Rymal C, Koppolu P, et al. Can a practicing surgeon detect early lymphedema reliably? Am J Surg. 2003; 186: 509-513. Ref.: https://goo.gl/pUUcKM
  10. Stout NL, Brantus P, Moffatt C. Lymphoedema management: an international intersect between developed and developing countries. Similarities, differences and challenges. Glob Public Health. 2012; 7: 107-123. Ref.: https://goo.gl/A34fVH
  11. Kung TA, Champaneria MC, Maki JH, Neligan PC. Current concepts in the surgical management of lymphedema. Plast Reconstr Surg. 2017; 139: 1003-1013. Ref.: https://goo.gl/GR2GPk
  12. Boccardo F, Fulcheri E, Villa G, Molinari L, Campisi C, et al. Lymphatic microsurgery to treat lymphedema: techniques and indications for better results. Ann Plast Surg. 2013; 71: 191-195. Ref.: https://goo.gl/jhE6o4

Figures:

Figure 1

Figure 1

Figure 1

Figure 2

Figure 1

Figure 3

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More

Help ?