CDT is the most successful treatment for chronic extremity lymphedema. Post mastectomy lymphedema and other related conditions respond extremely well to this gentle, non-invasive and highly effective therapy. CDT is sometimes referred to as Complete Decongestive Physiotherapy (CDP) or Complex Decongestive Physiotherapy.
CDT is a combination of MLD, bandaging of the affected areas, exercises and skin and nail care. CDT is usually divided into a two-phase program that first involves an intensive treatment phase, followed by a maintenance program that the patient continues at home. When carried out with great care, consistency and the expertise of a well-trained therapist, CDT is the treatment of choice for chronic extremity lymphedema. Even in advanced lymphedema, CDT can be used (free of side effects) with great success. Because CDT is labor intensive, time consuming and requires patient compliance, many patients have difficulty committing to the program at first. Nevertheless, because the results of CDT are superior to other available treatments, most patients undergo CDT treatment and are then able to maintain the reduction of their limbs by diligently participating in a home based self care program.
Since CDT is fairly new in the United States, staff training and treatment standards vary a great deal from clinic to clinic. It is important that the CDT training that a lymphedema therapist received consists of all components of CDT (basic and advanced MLD, lymphedema bandaging, exercises, skin and nail care). The therapist must also have a complete understanding of the anatomy, physiology and pathophysiology of the lymphatic system, the treatment of primary and secondary lymphedema, the indications and contraindications of MLD/CDT, as well as the measuring techniques for lymphedema support garments. Further, lymphedema therapy should not begin unless the patient has been examined and diagnosed by a board-certified physician who understands lymphedema and its complications. Once the diagnosis of lymphedema has been confirmed and treatment has begun, the progress must be monitored by the physician. Whereas the clinical diagnosis of lymphedema can most often be established without invasive testing, an electrocardiogram before the treatments begin and during the course of treatment is sometimes necessary to ensure safe treatment for each patient. Lymphangioscintigraphy (LAS), CT scans and MRIs are recommended to some lymphedema patients before they start CDT. The physician will be able to decide and inform the patient about the necessity of such procedures at the time of consultation. Because of the complications associated with lymphedema, the involvement and supervision of a qualified physician is essential in order to provide safe and effective lymphedema therapy.
Source: Klose Training & Consulting
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