Complex physical therapy of the lymphoedematous leg

Abstract

Complex physical therapy (CPT) was used to treat 128 lymphoedematous legs (55 had unilateral lymphoedema), 22 (8) had Grade 1 lymphoedema, 84 (40) Grade 2, and 19 (7) were elephantiatic. CPT involves (1) skin care and hygiene, (2) special lymphatic massage, (3) compression bandaging during the course and compression garments following it, (4) special exercises. After the first 4-week course of CPT, the mean losses were 1.1, 1.3, and 3.7 liters, respectively, for the various grades (all,p < 0.0001). Unilateral edemas were reduced by 81, 51, and 57%, respectively (all,p < 0.0001). Eight were reduced to less than the normal leg. With adequate compression garments, these reductions were maintained for the next 11 months; there were small further reductions (p<0.05−0.001). Six patients, who were fitted with Tubigrip rather than with adequate garments, had a significant increase over this period. Some patients had a second course of CPT with similar proportional reductions in the remaining edema as those from the first course.