Assessing the Effectiveness of the Long-Term Use of Juzo’s Soft Compress Leg Liner to Manage Lower Extremity Lymphedema: A Case Study

Background and Purpose: Lymphedema is a chronic condition most commonly seen within the arms or legs. This condition causes tissue to swell secondary to a genetic disorder, excessive fluid loads in the body, or poor circulation or drainage of lymph fluid. Compression garments have proven to be a beneficial component of rehabilitation when treating patients with lymphedema. The Juzo Soft Compress Garment is a specific type of compression garment that can selectively increase the compression pressure for particularly localized edema. The purpose of the following case study is to analyze and share the outcomes related to long-term use of the Juzo Soft Compress Leg Liner with short stretch bandages to manage lymphedema across three episodes of treating lower extremity lymphedema. Methods and Procedures: An 80-year-old-female patient presented to physical therapy with a medical diagnosis of lymphedema (ICD-10: I89.0). The patient reported left lower extremity swelling, heaviness, and decreased mobility/difficulty ambulating on the first visit of each episode of treatment. The clinician discussed the examination, evaluation, and plan of care process with the patient. The clinician obtained permission to use gathered data to write a case study. To determine the effects of the treatments, the clinician used the following tests and measures and outcome measurement tools: Lower Extremity Girth Measurements, the Lower Extremity Functional Scale (LEFS), Numeric Pain Rating Scale (NPRS), and the Two- Minute Walk Test. The clinician took and reassessed objective lower extremity (leg) girth measurements using a tape measure at each treatment session as well as at each initial examination and discharge. The patient's treatment sessions primarily included manual lymph drainage (MLD), Soft Compress Leg Liner and short stretch bandaging application, and self-care and patient education. The clinician had over 10,000 hours of practice as a certified lymphedema therapist prior to each episode of treatment. The clinician thoroughly discussed the examination, evaluation, and plan of care process with the patient. Results: From the patient's first initial evaluation session of the first episode of treatment to the third discharge of the third episode of treatment, the patient's total left lower extremity (leg) girth measurements had improved from 176.7 centimeters at the initial evaluation of the first episode of treatment to 160.1 centimeters at discharge of the third episode of treatment. Discussion: The results for the patient in this case study utilizing Juzo's Soft Compress Leg Liner with multiple short stretch bandages for long-term use to manage lower extremity lymphedema proved to be effective in reducing girth measurements and in improving lymphatic circulation. Adjunct treatments and outlying factors, such as manual lymph drainage techniques and patient compliance with lymph drainage therapeutic exercises, could have affected or influenced the outcomes of this case study. In addition, Juzo's Soft Compress Leg Liner proved to be durable being that the patient used the same Soft Compress Liner for each episode of care. Conclusion: The results of this case showed that the long-term use of Juzo's Soft Compress Leg Liner with multiple short stretch bandages could be an effective treatment to manage lymphedema in lower extremities. However, these results could differ between patients depending upon compliance and the utilization of other adjunct treatments. Further studies are highly recommended with a larger sample size for generalizability.