Brian T. Swanson
© 2015 Snezhana Rudakova
Background and Purpose: Ninety percent of stroke survivors have some functional disability with mobility and paralysis of the extremities being a major impairment. A paralysis of the extremities can result in an ineffective muscle pumping action, which can lead to the development of lymphedema, further increasing difficulty with ambulation post stroke. The purpose of this case is to report the use of complete decongestive therapy for the treatment of lymphedema as part of a comprehensive treatment program consisting of a task-oriented approach to improve walking ability in a stroke survivor. Case Description: The patient was a 53 year old female six months s/p stroke who developed right lower extremity lymphedema. She presented with deficits secondary to CVA with right sided hemiparesis including decreased range of motion and decreased strength in the right lower extremity, as well as increased tone and spasticity throughout the right upper extremity and lower extremity. Her decreased strength, impaired balance, and increased limb heaviness contributed to her difficulty with ambulation and ADL’s. Outcomes: She experienced a 1.0 cm-5.0 cm reduction in various areas of circumference measurements of the right lower extremity with no signs or symptoms of infection. Her gait mechanics and gait speed improved in conjunction with a decrease in disability of 39% (Tinetti). Discussion: Despite her chronicity post-stroke, use of a task-oriented approach consisting of both strength and intensive mobility training improved the patient’s ambulation and increased her independence with ADL’s. Complete decongestive therapy was effective in reducing the swelling of the right lower extremity, further contributing to improvement with ambulation.
Rudakova, Snezhana, "Use Of Complete Decongestive Therapy And A Task-Oriented Approach In Treating Secondary Lymphedema And Improving Ambulation In A Patient Following A Stroke: A Case Report" (2015). Case Report Papers. 48.