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Protein-Rich Edema: Lymphedema
Protein-Rich Edema: Lymphedema
A. LYMPHEDEMA
● Most common result of a disrupted lymphatic system
● It is the aggregation of protein-rich edema in the interstitium due to the failure of the
lymphatic system to properly meet demands.
● (+) ↑ interstitial colloidal osmotic pressure which leads:
○ ↑ blood capillary filtration
○ ↓ blood capillary reabsorption
● Possible consequence of breast cancer surgery
● Will progress if not reversed
Take note: BMI is directly proportional with the severity of arm edema
E. ADDITIONAL PRACTICES FOR ● Refrain from sustained sitting, crossing of legs, &
LOWER EXTREMITY standing
● Wear proper fitting shoes
F. EXTREMES OF TEMPERATURE ● Exposure to extreme temperatures is not advisable
● Refrain from placing limb in water with temperature
of >38.9 °C
D. STAGES OF LYMPHEDEMA
STAGES CHARACTERISTICS
ADVANTAGE DISADVANTAGE
F. BENEFITS OF COMPRESSION
✓ Reduction in the quantity of lymph to be moved by the lymphatic system
✓ Improvement in lymphatic & venous returns (distal → proximal)
✓ Leads to more effective muscle pump on contraction
✓ Makes hardened fibrotic tissue in advanced stage softer
✓ Supports tissue that has diminished or no elasticity
G. GARMENT SELECTION
COMPRESSION LEVEL TYPE OF KNIT (CIRCULAR VS. FLAT)
H. EXERCISE PRINCIPLES
● Works best when an exercise principle is followed
● Exercises extremities that have sufficient compressions
● Gradual progression of exercises based on frequency, intensity, and mode
● Observe the shape & size of the extremity involved and provide adjustments on interventions
LIPEDEMA
LIPEDEMA
● Symmetrical build-up of fats in tissue that is progressive
● Unusual
● Commonly seen in the buttocks and LE
● Frequently appears in menopausal, pregnant, adolescent females
● Rare in males
● Genetic → present in >1 woman in the family
MANIFESTATIONS
● Distribution
○ Bilateral (LE > UE)
○ Affects proximal areas (e.g. thigh, buttocks)
○ Rarely on feet
● Effects on Skin
○ ↓ elasticity
○ Pressure sensitive
○ Prone to bruises
Reference:
● Hillegass, E. (2017). Essentials of Cardiopulmonary Physical Therapy (4th ed.). Elsevier: St.
Louis, Missouri