Development of a framework for pneumatic device selection for lymphedema treatment
Identifieur interne : 003766 ( Pmc/Checkpoint ); précédent : 003765; suivant : 003767Development of a framework for pneumatic device selection for lymphedema treatment
Auteurs : Sonja M. Maul [États-Unis] ; Julie A. Devine [États-Unis] ; Carolyn R. Wincer [États-Unis]Source :
- Medical Devices (Auckland, N.Z.) [ 1179-1470 ] ; 2009.
Abstract
The results of three patients with difficult to manage leg and trunk lymphedema are reported. Patients were treated with the current standard of care: combined decongestive therapy. All three patients met obstacles in achieving independent self-care, which impeded their discharge to home care. The use of two currently available programmable pneumatic compression devices (PCDs) was investigated to determine if these devices could enable these difficult-to-manage patients to meet their discharge goals. Results indicate that programmable PCDs can be effective in managing complicated cases of leg and trunk lymphedema, and that differences may exist between devices. In this trial, the device with lower applied pressures and smaller pneumatic chambers provided better tolerated treatment and overall better patient outcomes. These three case reports show that in-home use of an appropriate PCD can help patients with stage 3 and advanced stage 2 lymphedema achieve stable limb volumes with no exacerbation of lymphedema-related symptoms. Results also demonstrate the ability of patients to consistently use programmable PCDs in a home environment. The results are presented in a structured decision-making framework to aid the therapist and physician in selecting appropriate patients for home PCD lymphedema therapy, and in the selection of an appropriate PCD.
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PubMed: 22915915
PubMed Central: 3417860
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Development of a framework for pneumatic device selection for lymphedema treatment</title><author><name sortKey="Maul, Sonja M" sort="Maul, Sonja M" uniqKey="Maul S" first="Sonja M" last="Maul">Sonja M. Maul</name><affiliation wicri:level="1"><nlm:aff id="af1-mder-2-057">St. Luke’s Idaho Elks Rehabilitative Services, Boise, ID, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>St. Luke’s Idaho Elks Rehabilitative Services, Boise, ID</wicri:regionArea><wicri:noRegion>ID</wicri:noRegion></affiliation></author><author><name sortKey="Devine, Julie A" sort="Devine, Julie A" uniqKey="Devine J" first="Julie A" last="Devine">Julie A. Devine</name><affiliation wicri:level="1"><nlm:aff id="af2-mder-2-057">Center for Wound Care, Butler Memorial Hospital, Butler, PA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Wound Care, Butler Memorial Hospital, Butler, PA</wicri:regionArea><wicri:noRegion>PA</wicri:noRegion></affiliation></author><author><name sortKey="Wincer, Carolyn R" sort="Wincer, Carolyn R" uniqKey="Wincer C" first="Carolyn R" last="Wincer">Carolyn R. Wincer</name><affiliation wicri:level="1"><nlm:aff id="af3-mder-2-057">Centers for Rehabilitation Services, Gibsonia, PA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Centers for Rehabilitation Services, Gibsonia, PA</wicri:regionArea><wicri:noRegion>PA</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">22915915</idno><idno type="pmc">3417860</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3417860</idno><idno type="RBID">PMC:3417860</idno><date when="2009">2009</date><idno type="wicri:Area/Pmc/Corpus">002344</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002344</idno><idno type="wicri:Area/Pmc/Curation">002343</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002343</idno><idno type="wicri:Area/Pmc/Checkpoint">003766</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">003766</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Development of a framework for pneumatic device selection for lymphedema treatment</title><author><name sortKey="Maul, Sonja M" sort="Maul, Sonja M" uniqKey="Maul S" first="Sonja M" last="Maul">Sonja M. Maul</name><affiliation wicri:level="1"><nlm:aff id="af1-mder-2-057">St. Luke’s Idaho Elks Rehabilitative Services, Boise, ID, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>St. Luke’s Idaho Elks Rehabilitative Services, Boise, ID</wicri:regionArea><wicri:noRegion>ID</wicri:noRegion></affiliation></author><author><name sortKey="Devine, Julie A" sort="Devine, Julie A" uniqKey="Devine J" first="Julie A" last="Devine">Julie A. Devine</name><affiliation wicri:level="1"><nlm:aff id="af2-mder-2-057">Center for Wound Care, Butler Memorial Hospital, Butler, PA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Wound Care, Butler Memorial Hospital, Butler, PA</wicri:regionArea><wicri:noRegion>PA</wicri:noRegion></affiliation></author><author><name sortKey="Wincer, Carolyn R" sort="Wincer, Carolyn R" uniqKey="Wincer C" first="Carolyn R" last="Wincer">Carolyn R. Wincer</name><affiliation wicri:level="1"><nlm:aff id="af3-mder-2-057">Centers for Rehabilitation Services, Gibsonia, PA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Centers for Rehabilitation Services, Gibsonia, PA</wicri:regionArea><wicri:noRegion>PA</wicri:noRegion></affiliation></author></analytic><series><title level="j">Medical Devices (Auckland, N.Z.)</title><idno type="eISSN">1179-1470</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The results of three patients with difficult to manage leg and trunk lymphedema are reported. Patients were treated with the current standard of care: combined decongestive therapy. All three patients met obstacles in achieving independent self-care, which impeded their discharge to home care. The use of two currently available programmable pneumatic compression devices (PCDs) was investigated to determine if these devices could enable these difficult-to-manage patients to meet their discharge goals. Results indicate that programmable PCDs can be effective in managing complicated cases of leg and trunk lymphedema, and that differences may exist between devices. In this trial, the device with lower applied pressures and smaller pneumatic chambers provided better tolerated treatment and overall better patient outcomes. These three case reports show that in-home use of an appropriate PCD can help patients with stage 3 and advanced stage 2 lymphedema achieve stable limb volumes with no exacerbation of lymphedema-related symptoms. Results also demonstrate the ability of patients to consistently use programmable PCDs in a home environment. The results are presented in a structured decision-making framework to aid the therapist and physician in selecting appropriate patients for home PCD lymphedema therapy, and in the selection of an appropriate PCD.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Ridner, Sh" uniqKey="Ridner S">SH Ridner</name></author><author><name sortKey="Mcmahon, E" uniqKey="Mcmahon E">E McMahon</name></author><author><name sortKey="Dietrich, Ms" uniqKey="Dietrich M">MS Dietrich</name></author><author><name sortKey="Hoy, S" uniqKey="Hoy S">S Hoy</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lawenda, Bd" uniqKey="Lawenda B">BD Lawenda</name></author><author><name sortKey="Mondry, Te" uniqKey="Mondry T">TE Mondry</name></author><author><name sortKey="Johnstone, Pa" uniqKey="Johnstone P">PA Johnstone</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wilburn, O" uniqKey="Wilburn 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Med Devices (Auckl)</journal-id><journal-id journal-id-type="iso-abbrev">Med Devices (Auckl)</journal-id><journal-id journal-id-type="publisher-id">Medical Devices: Evidence and Research</journal-id><journal-title-group><journal-title>Medical Devices (Auckland, N.Z.)</journal-title></journal-title-group><issn pub-type="epub">1179-1470</issn><publisher><publisher-name>Dove Medical Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">22915915</article-id><article-id pub-id-type="pmc">3417860</article-id><article-id pub-id-type="publisher-id">mder-2-057</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>Development of a framework for pneumatic device selection for lymphedema treatment</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Maul</surname><given-names>Sonja M</given-names></name><xref ref-type="aff" rid="af1-mder-2-057">1</xref><xref ref-type="corresp" rid="c1-mder-2-057"></xref></contrib><contrib contrib-type="author"><name><surname>Devine</surname><given-names>Julie A</given-names></name><xref ref-type="aff" rid="af2-mder-2-057">2</xref></contrib><contrib contrib-type="author"><name><surname>Wincer</surname><given-names>Carolyn R</given-names></name><xref ref-type="aff" rid="af3-mder-2-057">3</xref></contrib></contrib-group><aff id="af1-mder-2-057"><label>1</label>St. Luke’s Idaho Elks Rehabilitative Services, Boise, ID, USA</aff><aff id="af2-mder-2-057"><label>2</label>Center for Wound Care, Butler Memorial Hospital, Butler, PA, USA</aff><aff id="af3-mder-2-057"><label>3</label>Centers for Rehabilitation Services, Gibsonia, PA, USA</aff><author-notes><corresp id="c1-mder-2-057">Correspondence: Sonja M Maul, 600 North Robbins Road, Suite 101, Boise, ID 83702, USA, Tel +1 209 489 4040, Fax +1 208 489 4064, Email <email>smaul@ierh.org</email></corresp></author-notes><pub-date pub-type="collection"><year>2009</year></pub-date><pub-date pub-type="epub"><day>04</day><month>12</month><year>2009</year></pub-date><volume>2</volume><fpage>57</fpage><lpage>65</lpage><permissions><copyright-statement>© 2009 Maul et al, publisher and licensee Dove Medical Press Ltd.</copyright-statement><copyright-year>2009</copyright-year><license><license-p>This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.</license-p></license></permissions><abstract><p>The results of three patients with difficult to manage leg and trunk lymphedema are reported. Patients were treated with the current standard of care: combined decongestive therapy. All three patients met obstacles in achieving independent self-care, which impeded their discharge to home care. The use of two currently available programmable pneumatic compression devices (PCDs) was investigated to determine if these devices could enable these difficult-to-manage patients to meet their discharge goals. Results indicate that programmable PCDs can be effective in managing complicated cases of leg and trunk lymphedema, and that differences may exist between devices. In this trial, the device with lower applied pressures and smaller pneumatic chambers provided better tolerated treatment and overall better patient outcomes. These three case reports show that in-home use of an appropriate PCD can help patients with stage 3 and advanced stage 2 lymphedema achieve stable limb volumes with no exacerbation of lymphedema-related symptoms. Results also demonstrate the ability of patients to consistently use programmable PCDs in a home environment. The results are presented in a structured decision-making framework to aid the therapist and physician in selecting appropriate patients for home PCD lymphedema therapy, and in the selection of an appropriate PCD.</p></abstract><kwd-group><kwd>lymphedema</kwd><kwd>swelling</kwd><kwd>pneumatic</kwd><kwd>compression</kwd><kwd>flexitouch</kwd><kwd>lympha press</kwd></kwd-group></article-meta></front><floats-group><fig id="f1-mder-2-057" position="float"><label>Figure 1</label><caption><p>Case report 1: bilateral leg volume changes.</p><p><bold>Note:</bold><sup>a</sup>FT, flexitouch.</p></caption><graphic xlink:href="mder-2-057f1"></graphic></fig><fig id="f2-mder-2-057" position="float"><label>Figure 2</label><caption><p>Case report 2: bilateral leg volume changes.</p><p><bold>Note:</bold><sup>a</sup>FT, flexitouch.</p></caption><graphic xlink:href="mder-2-057f2"></graphic></fig><fig id="f3-mder-2-057" position="float"><label>Figure 3</label><caption><p>Case report 3: left leg volume changes.</p><p><bold>Notes:</bold><sup>a</sup>FT, flexitouch; <sup>b</sup>LPO, lympha press optimal.</p></caption><graphic xlink:href="mder-2-057f3"></graphic></fig><fig id="f4-mder-2-057" position="float"><label>Figure 4</label><caption><p>This diagram indicates the essential elements to be considered when deciding if use of a PCD should be considered.</p><p><bold>Abbreviations:</bold> CDT, combined decongestive therapy; MLD, manual lymph drainage; PCD, pneumatic compression device.</p></caption><graphic xlink:href="mder-2-057f4"></graphic></fig><fig id="f5-mder-2-057" position="float"><label>Figure 5</label><caption><p>This diagram indicates the essential elements to be considered when deciding which PCD to recommend once the decision is made that a PCD is indicated.</p><p><bold>Abbreviation:</bold> LPO, Lympha Press<sup>®</sup> Optimal™; FT, Flexitouch<sup>®</sup>; PCD, pneumatic compression device.</p></caption><graphic xlink:href="mder-2-057f5"></graphic></fig></floats-group></pmc><affiliations><list><country><li>États-Unis</li></country></list><tree><country name="États-Unis"><noRegion><name sortKey="Maul, Sonja M" sort="Maul, Sonja M" uniqKey="Maul S" first="Sonja M" last="Maul">Sonja M. Maul</name></noRegion><name sortKey="Devine, Julie A" sort="Devine, Julie A" uniqKey="Devine J" first="Julie A" last="Devine">Julie A. Devine</name><name sortKey="Wincer, Carolyn R" sort="Wincer, Carolyn R" uniqKey="Wincer C" first="Carolyn R" last="Wincer">Carolyn R. Wincer</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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