Hot of the Press June 2025
Article to ponder
Assessment of bilateral lower limb lymphoedema: the use of bioimpedance spectroscopy
Key Findings on Bioimpedance Spectroscopy in Bilateral Lower Limb Lymphoedema
- Sensitivity of BIS: Bioimpedance spectroscopy (BIS) effectively detects extracellular fluid accumulation in bilateral lower limb lymphoedema.
- Lack of Specificity: BIS cannot differentiate lymphoedema from other causes of swelling, such as obesity or venous insufficiency.
- Integration Required: Combining BIS with clinical history, physical assessments, and imaging methods improves diagnostic accuracy.
- Diagnostic Challenges: Variability in impedance measurements and normalization methods complicates detection thresholds.
- Clinical Utility: BIS is valuable for screening, early intervention, and monitoring lymphoedema progression but requires a multi-modal approach for definitive diagnosis.
Recommendations for clinical practice
- Develop improved normalization methods for BIS data to reduce variability and enhance diagnostic accuracy.
- Investigate combining BIS with advanced imaging techniques like ICG lymphography for comprehensive assessments.
- Focus on distinguishing lymphoedema from other causes of swelling, such as venous insufficiency or obesity-related edema.
- Promote an integrated diagnostic approach combining BIS, clinical history, and physical evaluations.
- Explore the use of BIS for ongoing monitoring and treatment outcome tracking in lymphoedema management.
Key Takeaway: Bioimpedance spectroscopy is a useful, non-invasive tool for detecting and monitoring bilateral lower limb lymphoedema, especially when combined with clinical assessment. While not diagnostic on its own, it enhances early detection and supports ongoing management.
We have collated some great articles and material published over the last month. Click on the links below to read the abstract or download the full paper.
Anatomy / Physiology /Pathophysiology
Assessing subcutaneous changes in lymphedema by subcutaneous tissue ultrasonography and pathological association
Tissue engineering approaches for lymphedema: biomaterial innovations and clinical potential
May-Thurner syndrome diagnosis and management with concurrent lymphedema - click for abstract
May-Thurner syndrome diagnosis and management with concurrent lymphedema
Management Strategies
Children and Young People with Lymphedema: The Education Need of Health Care Professionals - click for abstract
Children and Young People with Lymphedema: The Education Need of Health Care Professionals
Introduction: The education need of health care professionals (HCP) to provide good quality care to children and young people with lymphedema (CYPwL) was unknown. While understanding of pediatric lymphedema grows, families still report delays in accessing appropriate treatment and HCP have reported being ill-prepared.
Methods: A questionnaire was designed by phased process of literature search, focus group, and online consensus with international experts. The online survey, available in six languages, was distributed to HCP working with CYPwL by professional groups.
Results: Questionnaires were received from 507 responders from 33 countries. Specific education on the treatment of CYPwL is needed, even when HCP are adult lymphedema trained according to 80% of respondents. Greatest consensus on best practice was that a multidisciplinary team (MDT) with specialist knowledge is required to treat CYPwL, but almost one in five HCP working with CYPwL have no, or rare, access to such a team. Reducing infections and adapting compression/treatment for age and development were deemed most essential. A variety of learning resources are needed including films, videos, and webinars from clinical experts.
Discussion and Conclusion: This is the first international survey of the education need of HCP regarding CYPwL which include pathology, treatment, psychosocial care, and education of other professionals. Uppermost was knowing how to reduce infections and adapt compression and other treatments for age and development. Access to an experienced MDT was considered essential to support good clinical decision-making. Multimodal approaches are needed to address identified education need. Further research in individual countries and professions is recommended.:10.1089.0043
Enhancing outcomes in severe lymphedema through combined treatment strategies
Feasibility and Potential Benefits of Moderate Intensity Cycling in People Living with Lower Limb Lymphedema: A Pilot Randomized Controlled Trial