1. LymphaTouch® As a Tool for Manual Lymph Drainage:
A Therapist’s Perspective
Karlie Kimball, Student in Occupational Therapy
Faculty Advisor: Daniel Panchik, DSc., OTR/L, CLT-LANA  
Pictures:
Lymphatics-
LymphaTouch-
Lymphedema, swelling due to impaired flow of lymph fluid, is a result of interrupted lymph circulation of the lymphatic system. This project aims to review and synthesize literature regarding the physiology of the lymphatic system, in particular, lymph flow, treatment of lymphedema involving the use of manual lymph drainage (MLD), and technology advances in the use of negative pressure in treatment and intervention in lymph flow. In addition to the literature review and synthesis, one certified lymphedema therapist was interviewed and asked to provide commentary on her experience using an advanced technology, the LymphaTouch®.
Abstract
LymphaTouch® was created in 2009 by developers in Finland
Uses negative pressure and high-frequency vibrations to produce the effects of MLD
Negative pressure is used to stimulate fluid flow and heal fibrotic tissues
Pulls the tissue to increase lymph movement
Moves the tissue vertically and horizontally in order to move the anchoring filaments that cause the lymph to remain static
When these filaments are moved, endothelial cells open, causing lymph to be able to move
Higher frequency vibrations stimulate the superficial layer of lymphatic system
Lower frequency vibrations work to stimulate the deep layer of the lymphatic system
LymphaTouch® and Negative Pressure
Maureen McBeth, MPT, CLT-LANA was interviewed
Clinician of lymphedema as well faculty at Norton School of Lymphatic Therapy
Permission given to use her name
Has been working with patients with lymphedema for 14 years and using LymphaTouch ® for 5 years
Stated that using the device feels like “an extra pair of hands” when combined with MLD
Difficult to compare MLD from LymphaTouch because they are so different. MLD calms the whole nervous system, but the device activates the lymphatic system and affects local tissues
Can treat many different side effects from cancer treatment including lymphedema, cording, peripheral neuropathy, and other sensory deficiencies
“LymphaTouch ® can help you adapt to all of those problems”
Little research has been conducted to test the effect on cording, neuropathy, etc
Challenges: after 5 years of usage, handle is cracked, but all challenges are related to mechanical design and durability, not the outcomes
McBeth is working with the company to improve the overall design
Contraindications: patients with sensitive skin or taking blood thinners may have a “cupping” effect
Never had a patient with a negative response; does not cause pain
Vuorinen et al. (2013) suggested similar outcomes
Used in latency stage to see if the patient is having any subtle changes and help treat them early
Iivarinen et al. (2013) suggested similar outcomes
States that she believes it works best with cyclic pressure
Iivarinen et al. (2016) suggested that continuous was better; more research should be conducted
Clinical Commentary from Maureen McBeth, MPT, CLT-LANA
LymphaTouch ® Literature
The lymphatic system is a one-way system that transports lymph from the body cavities and interstitial spaces to the heart; plays large role in immune response (McLafferty et al., 2012)
Lymph is watery fluid that carries clotting factors, fats, and proteins
Lymphedema is a disruption of the lymphatic system causing accumulation of lymph
Can be classified as primary or secondary (Buragadda et al., 2015)
Lymphatic System and Lymphedema
Authors
Research and Findings
Airakisinen, Vuorinen, and Raittila (2011)
18 patients treated; edema and perceived pain measured before and after treatment
20 minutes treatment sessions
Patients with shoulder, neck, knee edema showed significant pain decrease; elbow edema a moderate decrease
Suggests LymphaTouch® is a safe form of pain reduction
Vuorinen, Ivarinen, Jurvelin, and Airaksinen (2013)
13 women with upper extremity lymphedema as a result of mastectomy
LymphaTouch® group and MLD group
10 treatments lasting for 90 minutes
Significant changes in tissue stiffness, degree of disability, limb volume
Suggests LymphaTouch® is a positive and safe treatment that does not have adverse effects
Iivarinen, Korhonen, Julkunen, and Jurvelin (2013)
Looked at LymphaTouch® and its contributions to soft tissue changes
Tested forearm while resting and while experiencing venous occlusion
Found that LymphaTouch® can be used to diagnose and screen for changes in soft tissue in addition to lymphedema and other swelling conditions
Iivarinen, Korhonen, & Jurvelin (2016)
Looked at cyclic or continuous LymphaTouch® protocols
11 participants were placed into either cyclic or continuous protocols
Cyclic: pressure varies to allow skin to move and then stop
Continuous: continuous pressure
Continuous pressure found to have more efficient fluid movement
Found that negative pressure models can increase free movement of fluid
Osborne and Newell (2015)
Used two phases, subfascial and superficial, to reach both deep and superficial lymphatic systems
Purpose was to move the lymph from the deep system to the superficial system
Reduced inflammation, proteolytic activity, adipose tissue, and fibrosis
Occupational therapy is necessary because lymphedema decreases quality of life, work and leisure participation, and impairs occupational engagement (Pergolotti et al., 2016)
Complete Decongestive Therapy (CDT) is well recognized as an effective form of treating lymphedema
CDT aims to reduce the swelling in the limbs to either a “normal” state or to a state where the size of the limb has stabilized (Quirion, 2009)
Four steps within CDT
Manual Lymph Drainage
Uses light touch to move the lymph through altering lymph flow through normal healthy lymphatics and lymph node basins
Compression bandaging
Opens up lymphatic tracts and keeps them stimulated to prevent the accumulation of lymph
Meticulous skin care
Remedial exercises
Treatment of Lymphedema
A complete list of references is available upon request
References
Elizabethtown College Occupational Therapy Department
Maureen McBeth, MPT, CLT-LANA
Acknowledgements