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Aim:

Chronic edema of the lower leg has a negative impact on functional performance. Chronic edema impairs foot wear use and normal gait patterns, impairs calf muscle pump and most importantly limits the patient’s ability to interact with his/her environment. This negative spiral of progressive edema and progressive decline in functional status can be

reversed simply by addressing the edema.

Method:

Observational study performed at 2 separate outpatient edema management clinics. Eight patients were referred for lower extremity edema management to a physical therapist. Objective data measured including limb volume, ankle range of motion (ROM), functional activity status utilizing the Timed Up and Go (TUG) and the 4 meter walk test (4MWT), and assessment of quality of life (QOL) via the Lymphoedema QOL tool (LYMQOLLeg). Measurements were taken at initial evaluation, upon completion of treatment, and 2 weeks post treatment. Patients received compression therapies* and instruction in home exercise program only. Gait training was performed during the sessions for safety with assistive device when appropriate.

Results / Discussion:

Reduction of swelling had a direct positive impact on all outcomes measured. LYMQOL-Leg scores and functional performance scores (TUG and 4MWT) improved by 15% and 0.1m/sec respectively. Functional performance continued to improve after active therapy had been discontinued with further increased TUG scores at the 2-week follow-up assessment. The reduced edema allowed for normal footwear use, normalized gait patterns which increased mobility and enhanced QOL.

Conclusion:

Management of lower extremity edema has a positive impact on both patient’s functional status and QOL.