Randomized, Controlled, Crossover Trial Comparing Immediate Effects of Components of Complex Decongestive Therapy in Lower-limb Lymphedema Patients.
6 affiliations
- 1Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.
- 2Department of Rehabilitation Medicine, Saiseikai Kanagawaken Hospital, Yokohama, Japan.
- 3Department of Rehabilitation Medicine, Keio University Graduate School of Medicine, Tokyo, Japan.
- 4Department of Rehabilitation Medicine, Tokai University School of Medicine, Isehara, Japan.
- 5Department of Rehabilitation Medicine, National Hospital Organization Saitama Hospital, Wako, Japan.
- 6Department of Rehabilitation Medicine, Keio University Hospital, Tokyo, Japan.
Abstract
Objectives
Complex decongestive therapy is recommended as a standard treatment for lymphedema. It comprises skin care, manual lymphatic drainage (MLD), multilayered compression bandaging, and active exercise with compression therapy (AECT). Lower-limb elevation (LLE) is also widely used for adjunct treatment of lower-limb lymphedema (LLL). This study compared the immediate effects of each treatment component (MLD, AECT, and LLE) on LLL.Methods
Of the 24 participants who had developed LLL after a gynecological cancer surgery, 22 completed MLD, AECT, and LLE interventions, each performed for 30 min in a randomized crossover design. The main outcome was lower-limb volume as assessed by perometry. Other outcome measures included skin symptoms (stiffness and pitting, observed through palpation) and pain and heaviness (rated using a visual analog scale). Relaxation and improvement of lower-limb discomfort were evaluated quantitatively after the interventions. Statistical analyses of the main outcome used analysis of variance with a linear mixed-effects model. Subanalysis was performed on cases where the volume difference between the affected and unaffected limb exceeded 10% (severe cases).Results
: Lower-limb volume decreased significantly after all interventions (P <0.001). There was no significant difference between the three interventions across all cases (n = 22). In the subanalysis of severe cases (n = 19), lower-limb volume was significantly reduced after AECT relative to LLE.Conclusions
Our results showed that lower-limb volume significantly improved after each intervention. AECT was more effective than LLE for patients with more severe edema.
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BibTeX
@article{oka2026randomized,
title = {{Randomized, Controlled, Crossover Trial Comparing Immediate Effects of Components of Complex Decongestive Therapy in Lower-limb Lymphedema Patients.}},
author = {Asako Oka and Tetsuya Tsuji and Kiriko Abe and Takuya Nakamura and Michiyuki Kawakami and Kaori Muraoka and Hiroka Hohri and Yufuko Sano and Junichi Shoji and Michiyo Kamisako and Meigen Liu},
journal = {Progress in rehabilitation medicine},
year = {2026},
month = oct,
doi = {10.2490/prm.20260059},
url = {https://europepmc.org/article/MED/42948235},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Randomized, Controlled, Crossover Trial Comparing Immediate Effects of Components of Complex Decongestive Therapy in Lower-limb Lymphedema Patients.
AU - Asako Oka
AU - Tetsuya Tsuji
AU - Kiriko Abe
AU - Takuya Nakamura
AU - Michiyuki Kawakami
AU - Kaori Muraoka
AU - Hiroka Hohri
AU - Yufuko Sano
AU - Junichi Shoji
AU - Michiyo Kamisako
AU - Meigen Liu
PY - 2026
DA - 2026/10/28
JO - Progress in rehabilitation medicine
DO - 10.2490/prm.20260059
UR - https://europepmc.org/article/MED/42948235
AB - Objectives Complex decongestive therapy is recommended as a standard treatment for lymphedema. It comprises skin care, manual lymphatic drainage (MLD), multilayered compression bandaging, and active exercise with compression therapy (AECT). Lower-limb elevation (LLE) is also widely used for adjunct treatment of lower-limb lymphedema (LLL). This study compared the immediate effects of each treatment component (MLD, AECT, and LLE) on LLL.Methods Of the 24 participants who had developed LLL after a gynecological cancer surgery, 22 completed MLD, AECT, and LLE interventions, each performed for 30 min in a randomized crossover design. The main outcome was lower-limb volume as assessed by perometry. Other outcome measures included skin symptoms (stiffness and pitting, observed through palpation) and pain and heaviness (rated using a visual analog scale). Relaxation and improvement of lower-limb discomfort were evaluated quantitatively after the interventions. Statistical analyses of the main outcome used analysis of variance with a linear mixed-effects model. Subanalysis was performed on cases where the volume difference between the affected and unaffected limb exceeded 10% (severe cases).Results : Lower-limb volume decreased significantly after all interventions (P <0.001). There was no significant difference between the three interventions across all cases (n = 22). In the subanalysis of severe cases (n = 19), lower-limb volume was significantly reduced after AECT relative to LLE.Conclusions Our results showed that lower-limb volume significantly improved after each intervention. AECT was more effective than LLE for patients with more severe edema.
SN - 2432-1354
ER -