1. Effectiveness Of Occupational Therapy Interventions To Treat Edema ASOT 2014 VISION IN ACTION CONFERENCE Lauren Ehalt, OTS January 24 th, 2014

2. Objectives What is edema? How edema limits occupational performance? Interventions used to treat edema What does the evidence say? Practicality of interventions Fieldwork experience Overall implication Questions?

3. Edema Edema is swelling caused by fluid retention trapped in the body’s tissue. Swelling caused by edema commonly occurs in the hands, arms, ankles, legs, and feet. Classified using edema pitting scale How it is measured?

4. How edema affect occupational performance? Edema can affect ROM, pain tolerance, and overall mobility/function This can limit a persons ability to complete their own ADL’s and everyday tasks such as kitchen tasks and pet responsibilities This can impede a person’s ability to return to work

5. Interventions to Treat Edema Traditional  Elevation  Light Retrograde Massage  Compression Garments (tubi-grip and compression glove/sleeve)  ROM Program  Splints Untraditional  Manual Lymph Drainage  Modified Manual Edema Mobilization (MEM)  Continuous Passive Motion Device  High Voltage Pulsed Current (TENS)  Intermittent Pneumatic Compression  Kinesiotape

6. What does the evidence show? Consensus among Occupational therapists  Jackson, T., Van Teijlingen, & Bruce, J. (2012). Decrease in edema  Noted with all articles but data not significant  Could be from small sample size or duration of treatment/intervention

7. What does the evidence show? Decrease in pain  Knygsand-Roenhoej, K., & Maribo, T. (2011)  Priganc, V., & Ito, M. (2008). Overall perception of disability and quality of life  Bongi, S. M., Del Rosso, A., Passalacqua, M., Miccio, S. and Cerinic, M. M. (2011) Symptom severity and function  Schmid, A. B., Elliott, J. M., Strudwick, M. W., Little, M., & Coppieters, M. W. (2012)

8. What does the evidence say? Traditional and untraditional interventions show decrease in edema, but data not significant All evidence showed edema secondary to stroke, surgery, trauma, etc. Small sample sizes Length of treatment and duration Volumetric vs. Circumferential measurements Comparison between interventions Practicality of interventions

9. Fieldwork Experience St. Vincents  Patient education, compression garments, elevation, and manual lymph drainage Southern Indiana Rehab Hospital  Compression glove, tubi-grip, kinesiotape, elevation and positioning, patient education

10. Overall Implications Arrangement/Collaboration of interventions to treat edema Preparatory activities leading to occupation based Change research criteria Continued research  Kinesiotape?

11. Questions Email: laurenehalt@gmail.comlaurenehalt@gmail.com