To Leduc or Vodder, that is the question? Occupational Therapists have accepted the challenge of being the specialists in the treatment of Lymphedema. Depending on the the categorization of the impairment there are two very different forms of treatment.
Lymphedema, which usually appears as swelling of the legs, is a condition that is caused when the lymphatic fluid exceeds the bodies natural lymphatic transport capacity. An abnormal amount of protein-rich fluid collects in the tissues of the affected area. Left untreated, this stagnant, protein-rich fluid not only causes tissue channels to increase in size and number, but also reduces oxygen availability in the transport system, interferes with wound healing, and provides a culture medium for bacteria that can result in Lymphangitis (infection).
There are two basic categorizations of Lymphedema:
Primary Lymphedema, defined as impaired lymphatic flow because of congenital malformation of the lymphatic vessels, accounts for only about 10 percent of all Lymphedema cases.
Secondary Lymphedema is acquired and represents the most common type of Lymphedema. Precipitating factors include surgical removal of the lymph nodes, traumatic injury to the lymphatic system, and fibrosis secondary to radiation.
Of the variety of possible treatments for patients with lymphedema, two of the most prominent are the Vodder Method and the Leduc Method. Fundamentally similar in that each treatment makes use of Manual Lymphatic Drainage, however the two are notably different.
The Vodder method involves a distinctive technique of manual lymphatic drainage (MLD) using a variation of pressure. Among the other aspects of the method are bandaging and garment compression, as well as education regarding exercises, skin care and lifestyle guidelines.
The Leduc method also involves a distinctive technique of manual lymphatic drainage, in addition to the use of a compression device, according to Anne-Marie Vaillant-Newman, PT, director of the North American training program for the Leduc method of lymphedema management. Other aspects of the method include specific nonelastic bandaging and compression garments. Patients are provided with advice concerning proper skin care, low-grade exercise and lifestyle guidelines.
Both methods have training courses and provide certifications at the end of each course. OTs are encouraged to seek out certifications from either the Dr. Vodder School International, which covers the complete program of manual lymphatic drainage, bandaging, garment review, exercise, diet/nutrition, and skin care, as well as orthopedic and venous-related edemas. The Leduc School gives you the complete program of treatment including manual lymphatic drainage, bandaging, garment review, exercise, diet/nutrition, and skin care, as well as a review of the use of compression devices.
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