Comparative results of non-operative multi-modal therapy for filarial lymphoedema

Abstract

A comparative analysis of different conservative modes of therapy for lymphoedema, largely of Filarial origin, was conducted in a trial therapy unit in Chengalpattu, a Filarial endemic district in Tamil Nadu. Results were compared using a single chambered intermittent pneumatic compression pump, heat therapy, and interferential therapy machines. The results showed improvement of limb size between 20% and 60% of possible reduction (where 100% would mean return of limb circumference to the same as that of the normal side). Pneumatic compression therapy, when used alone, showed the best results, which were significantly better than all others whether alone or in combination.

Figure 1

Measurement points in the legs

Figure 2

Arch Effect. Circumferential pressure (red arrows) is absorbed and spread circumferentially (thin black circle) along the line of maximum resistance (blue arrows)

Figure 3

The single chambered pump can only move fluid up near its upper margin. Pressure is applied gradually

Figure 4

The sequential pump moves fluid directly in an upward direction due to fast

Figure 5

Heat therapy machine - patients legs are enclosed in a dome heated by sixteen 100 Watt bulbs (outer cover not shown for clarity). Since Indian skins are darker, the heat may be absorbed at the epidermal level. Hence patient tolerance was lower and beneficial effect may be less