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Learning Objective 1: The learner will be able to have the knowledges and skills for the patients with secondary lymphedema.
Learning Objective 2:
Background; Lymphedema is a chronic problem causing distress and decreasing quality of life. Complex Decongestive Physiotherapy (CDP) is a standard of care, conducted by combining four kinds of physical therapies: skin care, manual lymph drainage (MLD), compression bandage and exercise.
Purpose; This prospective study assessed the outcomes of the care program based on CDP for the patients with lymphedema.
Methods; The care program for lymphedema was led by a group consisting of a nurse who has a license of CDP therapist, clinical nurses and medical doctors. The participants were five patients with secondary lymphedema. Their lymphedema stagings were from II to III by the International Society of Lymphology. They underwent MLD once or twice monthly and received health education for skin care, self-massage and exercise, and compression stockings.
Results; Three female and two male patients were enrolled in the study. Four of them with lower limb lymphedema had pain in walking and the limitation of their sphere of activity. The pain among other participants with upper lymphedema obstructed their daily lives such as cooking and changing their clothes. Also, the limb lymphedema circumference was reduced in the early stage of lymphedema by taking this program and doing self-care. However, it was difficult to reduce the grade in the cases where there were other self care issues eg, the consequences of cerebrovascular accident and so on.
Conclusion; The sample size was small, but the study suggested that this program was effective for patients with early stage of lymphedema and can do their self-care. The improvements were made in mobility, subjective symptom reduction, motivation to continue self-care. It is hard to apply the program in cases having upper limb mobile limitation by the consequences of cerebrovascular accident or orthopedic diseases.
This study was supported by Grant-in-Aid for Scientific Research(C) 18592359, JSPS.