XXI International Congress of Lymphology

September 26-29, 2007     Shanghai China

Giving Control Over Lymphoedema Back to Patients 

Results of a Clinical Trial of a Cycloid Vibratory Hand Held Massage Unit for Chronic Arm Lymphoedema

 Neil B Piller, B Heidenreich, A Moseley, S Birrell

Lymphoedema Assessment Clinic, Department of Surgery, School of Medicine, Flinders University and Medical Centre Bedford Park, South Australia.

e-mail:  neil.piller@flinders.edu.au

 Most patients never receive the ideal or necessary treatment from their health professional either due to costs, professional expertise or availability or travel issues.  Patients are generally willing participants in the management of non threatening chronic disorders such as lymphoedema.  In this study, 30 patients whose average lymphoedema duration was 30 months with an average volume difference over 600 ml, were provided with a hand held cycloid massage unit along with a prescribed treatment program based on truncal and limb fluid clearance.  Patients (or partner) were expected to use the massage unit to treat their limb daily.  Progress of the lymphoedema limbs were measured prior to treatment, at the end of the first treatment, and then at the end of each week for three weeks as well as at one month after the end of treatment using multi-frequency bio-impedance (fluids), perometry, (limb volume) tonometry (fibrotic induration) and using a range of subjective measures including impact on activities of living and quality of life.  All comparisons were with the normal unaffected limb and baseline.

Over 5.7% reduction in limb fluid volume was attained by the end of the first week of treatment increasing to 6.4% after 4 weeks with larger % reductions of up to 45% reported with larger limbs.  During the treatment program fibrotic induration progress was halted.  Most importantly (for the patients) there were statistically significant reductions in patient perception of limb heaviness, limb size and in range of movement with improvements of over 20% occurring by the end of the first week (range of movement, limb tightness, pins and needles).  While these reductions are generally not as great as some intensive health professional treatment programs, they do show patients can manage chronic arm lymphoedema very effectively once instructed how to do so.  This means patients in remote areas, or who cannot afford normal treatment costs or who do not have access to qualified health professionals now have an option for self management, thus empowering them for their health care.  An effective self management is also of benefit between visits to their health professionals to maintain and enhance professionally attained improvement.

ABSTRACT