Complete Decongestive Physiotherapy (CDP)
The treatment of chronic lymph drainage disturbances aims to normalize or at least improve the lymphatic transport. The intention is to achieve a sustained alleviation of discomfort and to counteract an increase of the clinical picture and the emergence of associated and secondary diseases.
The guidelines of the Society of German-Speaking Lymphologists (DGL) have set the following therapeutic goals:
- Improvement of the lymphatic drainage
- Softening of fibrosclerotic tissue alterations
- Reduction of the amount of connective tissue
- Improvement of any functional limb deficits, in order to increase the efficiency of the muscular as well as the joint pump
- Information on options for self-treatment (skin care, certain grips to perform a lymphatic drainage, techniques of the lymphological compression bandaging)
- Repatriation or reintegration of affected persons into their social environment, such as school, apprenticeship, study or profession
- Prevention of long-term care
- Improvement of quality of life
In order to achieve these aims, the complete decongestive physiotherapy (CDP) has proved to be particularly effective. The "classic" form of the CDP consists of the following therapeutic components:
1. Skin care
2. Manual lymphatic drainage (MLD)
3. Compression therapy (Bandaging or supply with flat-knit products)
Lympho-Opt has added the following two elements:
5. Proper nutrition
6. The patient's self-motivation
1. Skin care
This term summarizes all measures to prevent and/or treat skin diseases and damages which affect its barrier function. We focus on the restoration and stabilization of an adequate moisture and lipid content of the skin, on protection against or treatment of infections due to bacteria or fungi respectively stasis dermatitis.
2. Manual lymphatic drainage (MLD)
The MLD is a gentle massage technique to increase the formation of lymph and its flow. It is typically performed by physiotherapists who are trained for and certified and licensed for this specific method. The efficiency of a manual lymph drainage highly depends on the anatomical and pathophysiological knowledge of the physiotherapists.
3. Compression therapy
A compression therapy is carried out during the decongestion phase by using special bandages. Those bandages are changed daily and always adjust to the current size of the edema. Once the edema cannot be reduced any further, the compression therapy changes and flat-knit compression aids (maintenance phase) are used instead. The compression should be worn every day, except for nights.
The intermittent pneumatic compression therapy (IPC) - also called apparative intermittent compression (AIC) - has proven itself effective as a complementary measure in the clinical, the outpatient as well as the the domestic area. For this kind of therapy Lympho-Opt only uses special devices, consisting of 12 chambers (Lympha Press).
The compression therapy increases the pressure in the interstitial tissue and thus simultaneously fulfills a variety of functions:
- It counteracts the ultrafiltration, which means that less fluid enters the tissue
- It supports the resorption, which means that more fluid from the tissue is pumped into the venous blood vessels
- It reduces the distance between blood vessels and cells ("transit or diffusion course") and thus enables a better supply with vital substances and disposal of waste products
- It improves the function of the valves and the flow conditions inside the lymphatic vessels and veins, and thus the lymphatic and venous drainage
- It stretches the edema over a larger area, thus involving far more lymph vessels in the removal of the fluid
- It prevents the edema to swell up due to gravity
- It activates the muscle and joint pump and thus improves the venous and lymphatic drainage against gravity
- The external massage effect of the compressing and knitted fabrics stimulates the microcirculation, and thus intensifies the exchange of substances of the individual somatic cells
Exercise under compression activates the muscle and joint pump. This intensifies the outflow of lymphatic fluids as well as the return of venous blood to the heart. It is therefore important that patients with chronic lymph drainage disturbances learn certain exercises that promote decongestion and perform them several times a day (also at their workplace). A physical therapy and exercises are not only highly effective decongestive measures; besides that they also positvely impact the general health condition and the mind. Plus: They can be supported by certain respiratory therapies.
5. and 6. Nutrition and patient's self-motivation
Lympho-Opt offers various measures to help patients change their eating habits as well as increase motivation, self-confidence and joie de vivre.
The CPT is a 2-phase therapy
Phase I - the phase of decongestion - aims to achieve the mobilization of the congestive high-protein edema fluid and initiates - if present - the reduction of increased connective tissue. Those applications must be highly dosed which often requires an inpatient stay.
Phase II - the maintenance phase - serves for optimizing and preserving the achieved therapeutic success. It is included into the patient's daily life. The application dosage depends on the severity of the clinical picture.
Skin care with Microvase Gel
Manual lymph drainage
bandaging of leg
flat-knit for leg
flat-knit for arm
Intermittent pneumatic compression therapy (IPC)