engleski

Chronic Primary Lymphedema - Proper Physiotherapy Treatment Management Can Make a Difference

We present a case report of a 46-year old nurse with lower limb late onset, second degree primary lymphedema (PLE) diagnosed twenty years after symptoms onset. She was referred to Physiotherapy Laboratory at Department for Health Studies, University of Split for lymphedema treatment because her PLE symptoms got worse due to the summer heat, prolonged sitting and standing position at work and 2 year period without proper therapy in Clinical Hospital Centre due to the Covid 19 pandemic. Treatment management goals of PLE are reduction and stabilization of limb volume, prevention of complications and facilitation of patient self- management, favouring patient autonomy and improving the patient’s quality of life. PLE treatment was conducted through seven sessions of sixty minutes three times a week. Treatment sessions were consisted of education, limb circumference measurements, manual lymph drainage (MLD) followed by Partsch compression therapy protocol. Non padding low stretch bandage technique for lower extremities and skin care have been implemented on each session. Instructions for physical activity were made likewise. Significant volume reduction was successful despite long PLE duration. Compression garments specialist made measures for flat knitted stockings compression class III that are indicated for lymphedema and have important role in the maintenance phase of limb volume. There were significant changes in limb volume reduction, skin elasticity. There were significant changes in quality of life and physical function assessed using FACIT, IPAQ, HADS, MEDAS questionnaires. Despite the fact that PLE is chronic disease and it has been left untreated for over twenty years by proper PLE therapy management it is possible to achieve positive results and to maintained treatment results especially if you have motivated and properly educated patient.

primary lymphedema, compression garments, compressive therapy, Complete decongestive therapy, manual lymph drainage, circumference measurement, IPAQ

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