Effect of Advanced Pneumatic Compression Devices in the Treatment of Lymphedema: A Systematic Review and Meta-Analyses.

Lymphedema is a chronic, progressive impairment of the lymphatic system that can impact activities and quality of life. Research regarding conservative management of lymphedema primarily consists of complete decongestive therapy (CDT) and compression devices intended to promote lymphatic and venous return. Advanced pneumatic compression devices (APCDs) contain multiple programmable sleeves designed to mimic manual lymph drainage at home. This study aims to determine the effectiveness of APCDs in the treatment of lymphedema through the completion of a systematic review and meta-analysis. A systematic search of five databases was conducted, spanning the years 2010-2021. Only experimental designs of moderate or strong quality were chosen and final review set consists of twelve articles. APCDs are found to be effective for lymphedema treatment based on differences in pre- and post-intervention limb volumes and patient-reported outcomes. Two meta-analyses evaluated the impact of APCDs on both rates of cellulitis and manual therapy. Both analyses demonstrated significant decreases in rates after the APCD interventions. The data showed consistent reduction of limb volume and improved patient-reported outcomes, indicating that APCDs are generally effective as a complementary intervention to CDT in the maintenance phase of lymphedema treatment.