Authors: (including presenting author): :
CHOW KKY(1), LAM ATL(1), YAU CWS(2), TAM SKF(2), LEUNG AKC(3), POON MWY(1)
Affiliation: :
(1) Physiotherapy Department, Hong Kong Buddhist Hospital (2) Department of Medicine, Hong Kong Buddhist Hospital (3) Department of Clinical Oncology, Queen Elizabeth Hospital
Keyword 1: :
Palliative Care
Keyword 4: :
Complete Decongestion Therapy
Keyword 5: :
Kinesiology Taping
Introduction: :
Lower extremity lymphoedema is a common symptom affecting palliative care(PC) patients. As patient’s disease progresses, persistent tenderness, pain and heaviness over lower limbs greatly affect patient’s functional status. Managing lymphoedema in PC patients is deemed challenging, since they often poorly tolerate different components of ordinary complete decongestive therapy(CDT) such as compression bandaging. Physiotherapy Department of Hong Kong Buddhist Hospital(HKBH) has enhanced lymphoedema management program in November 2023 by integrating modified CDT approach with kinesiology taping(KT), aimed to provide PC patients a more comfortable and easier way to manage their lymphoedema effectively.
Objectives: :
To evaluate the service efficacy of lymphoedema management program on lower extremity lymphoedema in palliative care setting
Methodology: :
A retrospective review was performed. Patients suffered from lower extremities lymphoedema under PC in HKBH in-patient unit from November 2023 to December 2025 were reviewed. CDT’s components, such as manual lymphatic drainage(MLD) and compression therapy, were modified and integrated with KT to ensure better tolerance and comfort for PC patients. Outcome measures which included (1)limb circumference, (2)level of pain and leg heaviness in numeric rating scale(NRS), and (3)active range of motion(AROM) of hip, knee and ankle, were taken before and after 3-days of treatment.
Result & Outcome: :
32 patients who suffered from metastatic cancer or end stage renal disease were reviewed. No adverse event was reported in the study period. There was significant improvement in all outcome measures after 3-days of treatment. Lower extremity circumference was significantly reduced by 1.2cm at thigh(p=0.003), 1.9cm at calf (p=0.001), 1.1cm at the ankle(p=0.001), and 1.3cm at feet(p< 0.001), indicating up to 5.2% of size reduction in lymphoedema. Furthermore, patients’ reported pain and leg heaviness were significantly improved by 1.4 out of 10(p< 0.001) and 1.3 out of 10(p< 0.001) respectively. Regarding patient’s mobility, significant improvement was found in lower limb AROM. AROM of hip flexion, knee flexion and ankle dorsiflexion were improved from 72.5° to 81.3°(p=0.015), 88.0°to 92.3°(p=0.011) and 4.7° to 6.3°(p=0.012) respectively after treatment. Our result supported that enhanced lymphoedema management program was effective in managing signs and symptoms associated with lower extremity lymphoedema. With the ease of application and comfort it offers, techniques such as modified manual lymphatic drainage and kinesiology taping might be viable options for palliative care patients and their caregivers to self-manage lymphoedema at home efficiently and effectively.
