Artikel
Edema assessment and management practices primarily in the United States
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Autoren
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Victoria Priganc
- Clarkson University, Potsdam, United States
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Jacqueline Reese Walter
- Nova Southeastern University, Fort Lauderdale, United States
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Sandra Sublett
- Advanced Therapy Specialists, Cedar Rapids, United States
| Veröffentlicht: | 6. Februar 2020 |
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Gliederung
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Objective: To understand edema education and practice patterns among hand therapists (HT) and identify if there is a gap between what is known physiologically about edema and how it is managed.
Materials and Methods: Following IRB approval, a survey focused on edema education and management was distributed through the American Society of Hand Therapists. Percentages represented demographic data. Quantitative data were analyzed using Chi-Square. Qualitative data are currently being analyzed with expected completion by 11/2018.
Results: N=436 respondents: 92% occupational therapists (OT), 6% physical therapists (PT). Most reported working in an outpatient orthopedic (68%) or hand therapy clinic (60%).
Edema education training: Most received edema management training, including the difference between acute/subacute/chronic edema, and the role of the lymphatic system in edema management through on-the-job training or continuing education. HTs trained with a PT degree were more likely to be taught the difference between acute/subacute/chronic edema (p <.05) and the role of the lymphatic system in edema management (p <.05) in their entry-level education compared to HTs with an OT degree.
Edema practice patterns: The most common assessment tool was circumferential measurements (n=421); the most common treatment technique was movement (n=364). HTs who are OTs and certified lymphedema therapists (CLT) were less likely to perform deep and light retrograde massage (p <.05) compared to OTs who were not CLTs. HTs who were PT and CLTs were less likely to perform deep retrograde massage (p <.05) compared to PTs who were not CLTs.
Qualitative analysis is in the final stage.
Conclusions: Addressing edema is a priority. To best treat edema, one must understand the role of the lymphatic system and recognize the type of edema, as treatment techniques should alter. It is important that HTs move beyond thinking about the lymphatic system for just clients with lymphedema, as persistent, high-protein edema can negatively impact all clients.
