The European Journal of Lymphology - Vol. XXI - Nr. 61 - 2010
Belgrado J.P, Bracale P, Bates J, Roh N, Rosiello R, Cangiano A, Moraine J.J
The evolution of lymphoedema during physical treatment appears quite easy to measure, especially if we limit ourselves to considering the decrease in its volume, and furthermore if we limit the volume’s measurement to the geometry of the arms, forearms, legs and thighs to a cylinder (lymphoedema reside mostly in these anatomical segments). On the other hand if we want to observe more complex anatomical areas such as the breast or scrotum, and especially when we take into account other parameters that are equally as interesting, such as the quality of the skin, it’s water density, the thickness of the dermis etc., the task of remaining precise becomes much more complex.
With regard to the measurement of the shape of the oedema, a series of pictures taken in standardized conditions (which are explained in detail below), can suffice for the analysis of the treatment’s results and the control of its efficiency. But how can we deal with more complicated geometries like the root of the limb, hands, feet, the face, breasts, external genitalia…and again other parameters that are less visible to the naked eye such as the thickness of the dermis, the variation of the subcutaneous tissue, the skin’s temperature, the quality of the skin, the tonicity of the oedema, the joint’s function, the quality of life, etc. All of them are measurable and important in the evaluation of the treatment’s efficacy. Regular measuring in the daily practice represents an important part in the assessment of the oedema’s evolution, and the more parameters the therapist can avail of, the better equipped they will be to adapt the treatment to each patient’s specificities. Another interesting application of the knowledge that can be obtained from measuring the affected area is the predictive factor or early indicator: detecting slight changes that are invisible to the naked eye, and thus availing of this information to commence treatment before the possible onset of a clinically significant lymphoedema.
Our aim is to discuss the most common parameters that are available for measurement, and the methods used to measure them, and to weigh their advantages and disadvantages to facilitate the comparison of different treatments and methods both on a theoretical level and in a practical setting.