Thermotherapy in the Treatment of Lymphedema

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Thermotherapy in the Treatment of Lymphedema

Postby patoco » Sat Dec 15, 2012 1:26 pm

Thermotherapy in the Treatment of Lymphedema

Dec. 2012

Thermotherapy is a concept not widely understood or even used by either lymphedema patients and/or threapists.

The concept which uses adjunct heat with complete decongestive therapy has actually been around for years. Because of disappointing results, not many studies have been done and indeed due to those results, it is not recommended as a valuable or effective treatment.

Thermotherapy and CDT (1)

Although CDT therapists typically advise against heat for a lymphedematous limb, thermotherapy has actually been proposed as a potential adjunct to CDT for treatment of lymphedema. Past studies have suggested that temperatures around 40 degrees celsius could potentially improve the transportation of lymph, and thereby decrease limb volume. While temperature changes will certainly elicit vascular responses, a role in CDT is unclear. A recent study (Mariana VF., de Fatima GG., Maria Pde G. The effect of mechanical lymph drainage accompanied with heat on lymphedema. J Res Med Sci. 2011 Nov;6(11):1448-51) examined this possibility by comparing mechanical lymph drainage (via a device that passively mobilizes limbs) with and without the addition of heat. In support of current clinical practice, reduction in limb volume for the lymphedematous limbs tended to be greater without heat, although the results were not statistically significant. The same conclusion was also observed for normal non-lymphedematous limbs. Although the results of this study were limited by an absence of long-term follow-up, and by the study’s narrow experimental design, the authors conclude that thermotherapy is not currently warranted as an add-on therapy to CDT. (1)

Use of Thermotherapy in Management of Lymphedema: Clinical Observations. (2)

Jan 1999
Campisi C, Boccardo F, Tacchella M.

Source

University School of Genoa, Department of Emergency Surgery, Microsurgery Center, Osp. S. Martino, Genoa, Italy

Abstract

We report clinical observations in 67 patients with chronic lymphedema undergoing hyperthermia. Our technique of hyperthermia is an alternative to microwave therapy, particularly where lymphangitis coexists in the same limb. Preoperative diagnostic evaluation including lymphatic and venous isotopic scintigraphy, Doppler venous flow metrics, and pressure manometry play an essential role in delineating the status of both the lymphatic and venous systems and in determining if hyperthermia is indicated. Our method of treatment consists of producing hot and humid ambience inside the chamber where the limb is situated. The data demonstrate the feasibility of our method of hyperthermia in 67 patients with postlymphangitis lymphedema (either arm or leg). Using this technique, improvement was seen in both limb function and edema.

Reference:

(1) Rehab Science Blog

(2) Springerlink
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