Authors (including presenting author) :
Lee PC (1), Yiu MK (1), Joyce Cheung TY (1)
Affiliation :
(1) Occupational Therapy Department, Tuen Mun Hospital
Introduction :
Currently in Tuen Mun Hospital (TMH) Occupational Therapy (OT) oncology conventional Lymphedema (LE) management, treatment modalities already include some of the components, including education, pressure garment and home exercise, in Complete Decongestive Therapy (CDT), which is the gold standard in treating lymphedema (NLN,2011). Some patients responded well to the current treatment; while some did not. To further enhance our LE management program, the rest of the CDT components, which include Manual Lymph Drainage (MLD), bandaging and different exercises, are suggested to be incorporated into our practice step by step. MLD is the first component to be incorporated as it is the least time consuming and less expensive treatment. Self- MLD is chosen instead of MLD as most of our current patients did not have carers to help them in MLD.
Objectives :
The aim of this project is to evaluate the feasibility and effectiveness of incorporating Self-MLD into our current LE practice. The objectives are to 1) reduce the stage of LE, 2) reduce limb circumference, 3) reduce subjective symptoms, and 4) evaluate the role of Self-MLD in empowering cancer survivorship.
Methodology :
Out-patients currently receiving OT service for lymphedema management, with good treatment compliance were recruited. Those with fair treatment compliance were excluded. Subjective symptoms, limb circumference, stage of LE were evaluated. In addition to conventional LE management treatment, Self- MLD education and practice were provided by the OT who had been trained as a Certified Lymphedema Therapist. Instruction sheet with specific sequence and regime of Self-MLD was provided for the home program. Follow-up sessions were provided according to patients’ learning progress. Patients’ comments were surveyed using a questionnaire.
Result & Outcome :
Five female patients, aged 53-69, were recruited. Four of them were in active rehabilitation and were diagnosed as breast cancer with unilateral upper limb (UL) LE stage IIA (n=1) to IIB (n=3); while one of them was under palliative care and was diagnosed as anal cancer with bilateral lower limb (LL) LE stage III. After the treatment with Self-MLD, all of the active rehabilitation cases showed decrease in LE stages; while the palliative case remained at stage III. None of the patients showed decrease in limb circumference; while all of them showed decrease in various subjective symptoms including heaviness, firmness, swelling, pain, and numbness. All patients agreed Self-MLD helped them in their LE management and increased their sense of control in their LE management.
