Comparison of the effectiveness of complex decongestive therapy and compression bandaging as a method of treatment of lymphedema in the elderly

Figures & data

Table 1 Description of the CDT applied in the subjects

Procedures	Number of procedures	Description
Manual lymphatic drainage	15	Central lymphatic drainage approx 15 minutes Local lymph drainage 45–60 minutes
Multi-layered bandaging*	15	Bandaging according to the scheme: Cotton bandage Cotton-wool bandage Foam sections (not in each case) Bandages with low stretch – on average 5–10 for the lower limb
Exercises	15	Duration of exercises: 45 minutes Components: Flexibility exercises Gentle resistance exercises Isometric exercises Breathing exercises Training on a cycloergometer

Note:

* An identical multi-layered bandaging scheme was applied in the MCB method.

Abbreviations: approx, approximately; CDT, complex decongestive therapy; MCB, multi-layer compression bandaging.

Table 2 Comparison of the lower limbs dimensions before and after the therapy

Groups	Parameters	Before treatment Mean±SD	After treatment Mean±SD	p-value
CDT (n=50)	Max circumference (cm)	51.4±12.9	48.9±11.6	<0.001
	Mean circumference (cm)	38.2±8.6	35.0±6.1	<0.001
	Volume (cm^3)	7,419.4±3,721.9	6,402.5±3,106.5	<0.001
MCB (n=53)	Max circumference (cm)	47.2±13.2	43.7±12.7	<0.001
	Mean circumference (cm)	35.8±6.7	32.9±6.6	<0.001
	Volume (cm^3)	5,858.0±3,988.1	5,041.9±3,718.0	<0.001

Abbreviations: CDT, complex decongestive therapy; MCB, multi-layer compression bandaging.

Table 3 Comparison of the investigated parameters between both groups of patients

Measures	Total	CDT (n=50)	MCB (n=53)	p-value
BMI (mean±SD)				0.010
Before treatment	30.3±4.4	31.1±3.8	29.5±4.7
95% CI	(29.5; 31.2)	(30.0; 32.2)	(28.2; 30.9)
After treatment	29.8±4.2	30.4±3.5	29.2±4.7
95% CI	(29.0; 30.6)	(29.4; 31.4)	(27.9; 30.5)
Difference	−0.5±0.5	−0.7±0.6	−0.4±0.4
95% CI	(−0.4; −0.6)	(−0.8; −0.5)	(−0.5; −0.3)
Max circumference (cm) (mean±SD)				0.005
Before treatment	49.2±13.1	51.4±12.9	47.2±13.2
95% CI	(46.7; 51.8)	(47.8; 55.1)	(43.5; 50.8)
After treatment	46.2±12.4	48.9±11.6	43.7±12.7
95% CI	(43.8; 48.6)	(45.6; 52.2)	(40.2; 47.1)
Difference	−3.0±2.4	−2.6±2.5	−3.5±2.3
95% CI	(−3.5; −2.6)	(−3.3; −1.8)	(−4.1; −2.9)
Mean circumference (cm) (mean±SD)				0.513
Before treatment	36.9±7.7	38.2±8.6	35.8±6.7
95% CI	(35.4; 38.4)	(35.7; 40.6)	(33.9; 37.6)
After treatment	33.9±6.4	35.0±6.1	32.9±6.6
95% CI	(32.7; 35.2)	(33.2; 36.7)	(31.1; 34.7)
Difference	−3.0±3.7	−3.2±4.9	−2.8±1.9
95% CI	(−3.7; −2.3)	(−4.6; −1.8)	(−3.3; −2.3)
Volume (cm^3) (mean±SD)				0.550
Before treatment	6,616.0±3,921.5	7,419.4±3,721.9	5,858.0±3,988.1
95% CI	(5,849.6; 7,382.4)	(6,361.7; 8,477.2)	(4,758.7; 6,957.2)
After treatment	5,702.4±3,485.7	6,402.5±3,106.5	5,041.9±3,718.0
95% CI	(5,021.2; 6,383.7)	(5,519.7; 7,285.4)	(4,017.1; 6,066.7)
Difference	−913.5±727.3	−1,016.9±844.0	−816.0±588.5
95% CI	(−1,055.7; −771.4)	(−1,256.8; −777.0)	(−978.2; −653.8)

Note: The difference of the measurement between pre- and post-treatment values.

Abbreviations: CDT, complex decongestive therapy; MCB, multi-layer compression bandaging; BMI, body mass index.