Article

Non-cancer-related lymphedema is frequently unrecognized
until it has advanced and, therefore, presents substantial management challenges.
Treatment for lymphedema reflects cancer research and not the distinct
complexities of non-cancer-related lymphedema. This case report describes an
outpatient intervention for a patient with non-cancer-related unilateral lower
extremity lymphedema. CASE DESCRIPTION: The patient was a 42-year-old woman who
was morbidly obese and had left lower extremity chronic stage III lymphedema.
Massive disfiguring lymphedema of her lower leg caused chronic wounds, pain,
difficulty ambulating, and the inability to lift her leg in transfers. The
patient received complete decongestive therapy (CDT) in an outpatient setting.
OUTCOMES: The volume of the patient's leg decreased more than 66%, so that her
massive lower leg was transformed to nearly the same size as her unaffected limb.
Proper compression management restored independent transfers and pain-free
ambulation. DISCUSSION: Delayed diagnosis and treatment of non-cancer-related
lymphedema result in increased severity and impaired mobility, making this a
unique, complex condition requiring modifications to CDT in the outpatient
setting. This case report demonstrates successful outpatient treatment of a
patient with severe unilateral lower extremity lymphedema associated with large
wounds and impaired mobility using CDT that was modified to accommodate her
complex medical status, transportation barriers, and health insurance
availability. Following 23 weeks of physical therapist interventions, the
patient's affected lower extremity was the same size as the unaffected lower
extremity, and she was independent in ambulation and stair climbing.
CI - (c) 2015 American Physical Therapy Association.

Langue : ANGLAIS