Overcoming Barriers in the Management of Lower Extremity Lymphedema Utilizing Advanced Pneumatic Therapy

ABSTRACT

Lymphedema often requires intensive, costly treatment which initiates in the clinic and is eventually selfadministered by the patient at home. In-clinic Complete Decongestive Therapy aims to reduce limb volume, improve mobility, and reduce the risk of infection. Maintaining these clinical gains requires that the patient continues the treatments at home. Self-administering these treatments, however, can prove difficult, leading to loss of the therapeutic gains achieved during the in-clinic phase, especially when clinicians must moderate the recommendations to adapt to a patient’s physical limitations and/or the demands of one’s social and work obligations. Adding an advanced pneumatic therapy device in the home may assist with overcoming barriers associated with the complex requirements of selfadministered lymphedema care. By providing a consistent, passive treatment option, patients may be better able to maintain the clinical progress achieved during in-clinic therapy. The purpose of this retrospective case review was to assess whether adding such a device to the at-home treatment regimen made a difference in the patient’s ability to manage lymphedema independently. This case study follows a patient with primary bilateral lower extremity lymphedema from initial in-clinic therapy through to her two year follow-up visit. Barriers to lymphedema management faced by this patient are identified, the clinical reasoning for the various treatment options tried is provided and the subsequent functional outcomes are presented. The case study suggests that the Flexitouch® system offers promise as an adjunct to in-home treatment for patients whose lymphedema has proven challenging to control.