Postural Stability in Patients with Lower Limb Lymphedema
Pınar Doruk Analan, MD1 and Emine Kaya, MD2. Lymphatic Research Biology 2019
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Postural Stability in Patients with Lower Limb Lymphedema
Pınar Doruk Analan, MD1 and Emine Kaya, MD2. Lymphatic Research Biology 2019
Background: Impaired mobility and musculoskeletal dysfunctions are commonly seen in patients with lymphedema and can affect the balance system in patients in whom the lower limb is affected. This study aims at comparing postural stability between patients with lower limb lymphedema (LLL) and healthy subjects.
Methods and Results: This controlled study included 36 patients with LLL (LLL group) and 36 healthy subjects (control group). Fall risk, stability index, and Fourier index measurements of Tetrax Interactive Balance System were compared. There were no statistically significant differences between groups in terms of demographics parameters (p>0.05). Some stability and Fourier index measurements were significantly higher in subjects in the LLL group than in the control group. However, the fall risk was not statistically different in patients with LLL than healthy subjects (p>0.05).
Conclusion: LLL may cause balance impairments. However, this impairment may not lead to increased fall risk. The evaluation of postural stability in LLL patients would be a useful addition to routine clinical practice due to the relationship between LLL and balance impairments.
Main findings
- Participants were divided into two groups: the lower limb lymphoedema (LLL) group and the control group. Patients who had been diagnosed with LLL were screened for eligibility from the outpatient clinics. After this stage, 36 patients (35 women and 1 man) were included in the LLL group. The control group included 36 healthy subjects (35 women and 1 man) randomly selected from individuals in the hospital employee population.
- The mean age was of the LLL group was 52.53 +/- 9.71 years and the control group 52.95 +/- 10.41. Future studies should include an older population to ascertain the impact of lymphoedema on balance in a population group where balance can be deteriorating and falls risk a real possibility.
- Static posturography was measured by using the Tetrax Interactive Balance System. It was used to evaluate the fall risk, stability index (SI), and Fourier index measurements.
- The SI indicates the degree of postural sway and tests an individual’s overall stability and capability of controlling and compensating for changes in posture. Higher fall risk and SI scores reflect diminished postural performance.
- The Fourier index is a regression analysis used to measure postural sway intensity through the Fourier transform, which shows a different frequency for each lesion that causes instability.
- Lower limb size difference measurements were taken by using a flexible nonstretch tape at the following levels: the metatarsophalangeal joint, ankle, 10cm distal to the distal margin of the patella, 10cm proximal to the proximal margin of the patella, and 20cm proximal to the proximal margin of the patella.
- LLL patients were evaluated with respect to lymphedema stage.
- The findings demonstrate that patients with LLL have balance system pathologies but these pathologies are not observed in all balance parameters. This balance impairment does not appear to lead to increased fall risk.
- The evaluation of postural stability would be a useful inclusion as part of routine clinical practice in LLL patients. Further studies including dynamic and static balance evaluations with a mix of lymphedema grades and studies using more objective methods of lymphedema may provide more objective results.
