Factors Associated with the Evolution in Quality of Life and Volume During the Maintenance Phase After a Multidisciplinary Intensive Treatment Program in Patients with Lower Limb Lymphedema.

RATIONALE: To evaluate which factors are associated with change in lymphedema-specific quality of life (QoL) and relative volume difference in the maintenance phase after a multidisciplinary intensive treatment program in patients with lower limb lymphedema(LLL).

METHODS AND

RESULTS

In this retrospective study, patients received a multidisciplinary intensive treatment followed by a maintenance phase. In this maintenance phase, patients were advised to perform skin care and exercises and to wear compression garments. Circumferential measurements and the Lymph-ICF-LL questionnaires to determine volume and the lymphedema-specific QoL, respectively, were collected at the start and end of the intensive treatment and at 6 months follow-up. Patient-, lymphedema-, and treatment-related variables were collected to investigate their association with change in lymphedema-specific QoL and relative volume in the maintenance phase. Mann-Whitney U and Spearman rank correlation tests were applied. Patients (n = 279) who did not receive physiotherapy between 5 and 6 months follow-up and had a lower %score on the 6-minute walk test at the start of the intensive treatment showed significant better improvement in physical function and general tasks/household in the maintenance phase, respectively. Younger age, concomitant lipedema, and a lower % volume reduction during intensive treatment were significantly associated with less relative volume increase in the maintenance phase.

CONCLUSIONS

Patients without physiotherapy around 5-6 months follow-up or with limited physical capacity at the start may perceive better improvements in certain lymphedema-specific QoL domains, while younger age, concomitant lipedema, and less initial volume reduction appear to be less predisposed to volume regain during the maintenance phase.