Date: 2/12/2013

New Tool helps Patients with Lymphedema

Outpatient Physical Therapy Coordinator and Lymphedema Specialist at Community Hospital Mary Pawlicki , PT, CLT-LANA uses a new measurement tool called a perometer to assess the arm of Griffith resident LeeAnn Allen. A laser beam scans the limb, incrementally measuring girth. Limb volume can be calculated in order to quickly and accurately monitor any changes in swelling and help to manage patients’ lymphedema.

Therapists and lymphedema specialists at Community Hospital are using a new measurement tool called a Perometer® that can make a significant difference in the quality of life for patients who struggle with lymphedema. The Perometer technology, donated by the Community Cancer Research Foundation, is one of only a select few being used by hospitals in the Midwest. The Foundation works to bring the latest advances in detection, diagnosis, treatment, education and prevention of cancer to area patients.

“A Perometer is a computerized, digital scanner that measures the size and volume of a patient’s limbs,” said Mary Pawlicki, PT, CLT-LANA. “An infrared light scans the limb, incrementally measuring girth. Limb volume can be calculated in order to monitor the slightest changes in swelling. This tool is useful for quickly and accurately assessing lymphedema and can also be used to help fit compression garments,” she said. “The Perometer with its exact precision is going to be much more accurate than when we take manual measurements, offering a much more customized fit.”

Nearly 400,000 women in the U.S. each year are affected by lymphedema - a condition that occurs from swelling in an extremity caused by an accumulation of fluid in the tissues.

“At Community Hospital, our team has been passionate about finding ways to make the lives of our patients more comfortable,” said Pawlicki. “Each day, we treat about six patients living with chronic lymphedema, and we often see each other two to three times a week, working diligently to manage the effects of the swelling. During therapy, we manually massage the lymphs to remove fluid; teach exercises that can be done at home to ease discomfort; provide skin care to prevent infection, and fit for a compression garment to reduce the size of the swollen limb,” Pawlicki said.

Typically, the most common clinical assessments used to measure limb girth and volume measurements include simple tape measurements or water displacement tests. These techniques can be both time consuming and labor intensive, and often result in inaccurate measurements.

The advanced digital infrared technology of the Perometer eliminates any potential human error and provides a precise, exact, computerized assessment of limb girth and volume that is completed in a matter of seconds. The Perometer has a frame that slides up and down the length of the patient’s arm or leg. Infrared rays capture a picture of the affected limb and calculate length, circumference and volume. Measurements take only a few minutes and are painless. The Perometer then transfers the measurement information to the computer, which records the information and provides a comparison to previously stored measurements.

“This one piece of technology significantly enhances our patient’s experience through improved consistency and speed,” said Sue Degroate, OTR, CLT. “In just 10 seconds, we can get a clear picture of the lymphedema’s progress and track specific areas where swelling is most severe. Measurements that previously took up to 15 minutes manually, now only take 1-2 minutes, leaving more time for other aspects of therapy,” she said.

“Using this advanced technology, we can identify the presence of lymphedema at the earliest stages, even with minimal changes in limb volume,” said Pawlicki. “Because the Perometer identifies even the most subtle increases in volume, we can start the most appropriate lymphedema treatment interventions in a timely manner, reducing any negative effects of prolonged edema in the affected limb.”

“Treatment, such as Complete Decongestive Therapy (CDT), including Manual Lymph Drainage (MLD), can be initiated promptly,” Pawlicki said. “CDT is considered the gold standard of care for lymphedema by leading authorities in the field of lymphedema treatment. Immediate treatment intervention is necessary to help avoid the significant swelling and physical dysfunction often associated with lymphedema. In addition, precise Perometer measurements are key in the fabrication of custom compression garments that are to be worn to maintain the extremity size once treatment has been completed,” she said.

Not only is the Perometer a great tool in therapy, but it can also be used in research and prevention. Community Hospital strives to find the most effective methods for treating and managing cancers, and the Perometer will be used proactively to help prevent lymphedema.

For more information about outpatient physical therapy at Community Hospital click here.