Evaluation of Pressure-Applying Accuracy in Multilayer Bandaging Among Physiotherapists Who Treat Lymphedema

Abstract

Abstract

Background:

Compression therapy is the only conservative treatment that has been shown to be effective for patients with lymphedema in randomized controlled trials. A commonly used classification system divides pressure into four categories ranging from mild to very strong. For lower limb edema, bandages with strong pressure were shown to be most effective. Recent studies indicate that many health care professionals use inadequate pressure. No study thus far has focused on therapists who are trained in lymphatic treatment.

Methods and Results:

Thirty-seven physiotherapists trained in lymphatic treatment were recruited. Each participant received a questionnaire concerning their competence in compression bandaging. The subjects were asked to apply bandages using strong and medium pressure in two practical trials. Using a PicoPress^® device, pressure was measured both directly after bandaging and 2 hours later; 75.68% of participants successfully applied the bandaging with moderate pressure, correctly at least once, and 62.16% managed to do so with high pressure. A trend in the results shows that the higher the sub-bandage pressure at the beginning, the more it dropped after 2 hours. There was high consistency in pressure application for strong and moderate pressure. No correlation was found between the parameters of the questionnaire and correct bandaging pressure.

Conclusions:

Most of the physiotherapists were successful, at least once, in applying bandages with the proper amount of pressure. It is possible that the nature of the lymphatic treatment contributes to their success. Participants were most accurate in applying moderate pressure; however, it is unclear what impact this pressure has on a leg with lymphedema.

Condensed Abstract

Compression therapy is the only conservative treatment proven to be effective for patients with lymphedema in randomized controlled trials. Studies show that many health care professionals use inadequate pressure. For this study, 37 physiotherapists trained in lymphatic treatment were asked to apply bandages using strong and medium pressure in two practical trials. A PicoPress^® device was used to measure sub-bandage pressure. The majority of physiotherapists were successful, at least once, in applying bandages with the correct amount of pressure. Participants were most accurate in applying moderate pressure; however, it is unclear what impact this pressure has on a leg with lymphedema.