Rebecca Hammad1, Catherine Furbish2, W Mark Sweatman2, Edelle C Field-Fote2,3,4. 1. Crawford Research Institute, Shepherd Center, Atlanta, Georgia. Rebecca.Hammad@Shepherd.org. 2. Crawford Research Institute, Shepherd Center, Atlanta, Georgia. 3. Department of Rehabilitation Medicine, School of Medicine, Emory University, Atlanta, Georgia. 4. Program in Applied Physiology, School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia.
Abstract
STUDY DESIGN: Retrospective analysis of treatment data for a cohort of clients with spinal cord injury (SCI) who received therapy for management of edema. OBJECTIVE: To evaluate the safety, feasibility, and benefit of a modified lymphedema treatment approach for treatment of chronic lower extremity edema in persons with SCI. SETTING: A specialty rehabilitation hospital in Atlanta, GA, USA. METHODS: Certified lymphedema therapists with experience in SCI rehabilitation modified standard complete decongestive therapy (CDT) techniques to accommodate sensory and motor impairments and ensure skin safety. Therapists applied the modified CDT (mCDT) approach as part of treatment in 59 adults with SCI and lower extremity edema. Limb volume was measured using standardized volumetric measurement, pitting was scored using a standardized scale (range 0-4), and edema characteristics were determined to be present or absent. Outcomes of the mCDT intervention were analyzed for 105 lower extremities. RESULTS: Outcomes indicated that mCDT was associated with significant reduction in limb volumes, with a mean decrease of 11 ± 7.6%. Significant decreases were also observed in pitting edema and edema-specific characteristics, mean pitting scale score was reduced from a 3/4 to a 1/4. Minor adverse events were identified in a small number of patients. CONCLUSIONS: We found the mCDT approach to be safe and well-tolerated by the patients with SCI. The intervention was associated with decreased edema, and was feasible for use in a clinical setting. We recommend considering this mCDT approach for management of edema in individuals with SCI, while remaining vigilant about skin inspection.
STUDY DESIGN: Retrospective analysis of treatment data for a cohort of clients with spinal cord injury (SCI) who received therapy for management of edema. OBJECTIVE: To evaluate the safety, feasibility, and benefit of a modified lymphedema treatment approach for treatment of chronic lower extremity edema in persons with SCI. SETTING: A specialty rehabilitation hospital in Atlanta, GA, USA. METHODS: Certified lymphedema therapists with experience in SCI rehabilitation modified standard complete decongestive therapy (CDT) techniques to accommodate sensory and motor impairments and ensure skin safety. Therapists applied the modified CDT (mCDT) approach as part of treatment in 59 adults with SCI and lower extremity edema. Limb volume was measured using standardized volumetric measurement, pitting was scored using a standardized scale (range 0-4), and edema characteristics were determined to be present or absent. Outcomes of the mCDT intervention were analyzed for 105 lower extremities. RESULTS: Outcomes indicated that mCDT was associated with significant reduction in limb volumes, with a mean decrease of 11 ± 7.6%. Significant decreases were also observed in pitting edema and edema-specific characteristics, mean pitting scale score was reduced from a 3/4 to a 1/4. Minor adverse events were identified in a small number of patients. CONCLUSIONS: We found the mCDT approach to be safe and well-tolerated by the patients with SCI. The intervention was associated with decreased edema, and was feasible for use in a clinical setting. We recommend considering this mCDT approach for management of edema in individuals with SCI, while remaining vigilant about skin inspection.
Authors: P van der Meer; M W M Post; C M C van Leeuwen; H J M van Kuppevelt; C A J Smit; F W A van Asbeck Journal: Spinal Cord Date: 2016-07-19 Impact factor: 2.772
Authors: Jeanette Ezzo; Eric Manheimer; Margaret L McNeely; Doris M Howell; Robert Weiss; Karin I Johansson; Ting Bao; Linda Bily; Catherine M Tuppo; Anne F Williams; Didem Karadibak Journal: Cochrane Database Syst Rev Date: 2015-05-21
Authors: Liana Praça Oliveira; Reginaldo Florencio da Silva; Marie Aquino Melo de Leopoldino; Sarah Carvalho Frota; Gabriella Coelho Vieira de Melo Alves; Jefferson Pacheco Amaral Fortes; Pedro Henrique Gomes Muniz; Gisele Harumi Hotta; Francisco Carlos de Mattos Brito Oliveira; Francisco Fleury Uchoa Santos-Júnior Journal: Appl Bionics Biomech Date: 2022-09-16 Impact factor: 1.664