Graduation Year

2022

Document Type

Capstone

Degree Type

Open Access Capstone

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

Department Name when Degree Awarded

Occupational Therapy

Abstract

Background: There is a lack of clinical practice guidelines regarding treating phlebolymphedema symptomology. To facilitate client centered evidence-based practice, occupational therapists (OTs) who are Certified Lymphedema Therapists (CLTs) need disease specific evidence for treating phlebolymphedema. Finding available evidence regarding the use of complete decongestion therapy (CDT) for this population will support evidence-based practice. For this capstone compression usage is the one component of CDT that will be researched.

Purpose: A systematic review of evidence related to use of static compression for treatment of lower leg phlebolymphedema that is within the scope of a CLT who is not wound care certified.

Methods: Four databases were searched to extensively retrieve potentially eligible studies published between 2012 and 2022: Medline, Cochrane Central Registrar of Controlled Trials, CINAHL Ultimate, and Academic Search Ultimate. Findings were restricted to peer reviewed articles published in academic journals in the English language. Inclusion and exclusion criteria were defined. Eight randomized control trials (RCTs) were identified for inclusion. These articles were assessed for quality and strength of evidence.

Results. All eight articles were assessed to be low quality randomized control trials (RCTs). There was moderate strength of evidence to support use of Velcro wraps as compression garments to treat symptomology of phlebolymphedema, and moderate strength of evidence that the use of bandages is not always the best option during the decongestion phase of CDT for this population. The strength of evidence was low to support use of multilayer compression or compression with imbedded skin hydration is indicated for some people with phlebolymphedema.

Conclusions: This systematic review highlighted the lack of available practice guidelines, evidence and clinical recommendations for use of compression for treating symptomology of phlebolymphedema. Without RCTs with high methodological quality producing strong evidence, OTs who are CLTs are at risk for providing care that is not evidence based.

Faculty Mentor

Dana Howell, PhD, OTD, OTR/L, FAOTA

Department Affiliation

Occupational Therapy

Committee Member

Camille Skubik-Peplaski, PhD, OTR/L, FAOTA

Department Affiliation

Occupational Therapy

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