Changes in lymphatic function after complex physical therapy for lymphedema

Twenty-two extremities of 19 lymphedema patients (6 amis, 16 legs) were tre ated by 2 weeks of complex physical therapy (CPT) and self home maintenance therapy (bandage/ wearing of elastic garment and exercise). In addition to the clinical response of volume reduction before and 3 months after CPT, w e analyzed the functional changes of the peripheral lymphatic system by use of lymphoscintigraphy (LS). Before CPT, the main LS findings of lymphedema included dermal backflow (10 0%), absent or faintly visualized regional lymph nodes (95.5%), presence of collateral lymphatic vessels (68.2%), and no or barely visualized lymphati c vessels (27.3%). LS findings suggesting improved lymphatic function after CPT were a decrease in dermal backflow (72.7%), an increase in radioisotop e uptake by lymphatic vessels (27.3%), and an increase in radioisotope upta ke by lymph nodes (9.1%). 81.8% of limbs showed improved lymphoscintigraphi c findings and no change in 9.1%. In the others (9.1%), LS findings appeare d worse. There was, however, no correlation between LS "improvement" and th e amount of limb volume reduction.