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Article
Lymphedema techniques to manage edema after SCI: a retrospective analysis
Spinal Cord (2018)
  • Rebecca Hammad, Shepherd Center
  • Catherine Furbish, Shepherd Center
  • W. Mark Sweatman, Shepherd Center
  • Edelle Field-Fote, Shepherd Center
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.
Keywords
  • spinal cord injury,
  • lymphedema,
  • edema,
  • swelling
Publication Date
Summer June 12, 2018
DOI
https://www.nature.com/articles/s41393-018-0141-8.pdf
Citation Information
Rebecca Hammad, Catherine Furbish, W. Mark Sweatman and Edelle Field-Fote. "Lymphedema techniques to manage edema after SCI: a retrospective analysis" Spinal Cord (2018) p. 1158 - 1165
Available at: http://works.bepress.com/rebecca-hammad/1/