Lymphology 54 (2021) 140-153 LYMPHEDEMA DURATION AS A PREDICTIVE FACTOR OF EFFICACY OF COMPLETE DECONGESTIVE THERAPY E. Michopoulos, G. Papathanasiou, K. Krousaniotaki, I. Vathiotis, T. Troupis, E. Dimakakos Physiotherapy Department (EM,GP) and Laboratory of Neuromuscular and Cardiovascular Study of Motion-LANECASM (EM,GP,ED), University of West Attica; Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School (KK,IV,TT,ED), Athens, Greece ABSTRACT Lymphedema is a common condition with global impact and a multitude of complications, however, only a few professionals specialize in its management. A retrospective analysis of 105 subjects with unilateral lymphedema upper or lower limb was performed to investigate wheth- er the duration of lymphedema constitutes an important factor associated with the efficacy of complete decongestive therapy (CDT). Subjects were classified into two groups according to the duration of lymphedema, prior to CDT: group A (≤1 year) and group B (>1 year). Both groups were treated daily according to the same CDT protocol for four weeks. The CDT efficacy was determined based on the percent reduction of excess volume (PREV) measurements. Lym- phedema was significantly reduced in both groups of subjects, but significantly more in group A (p<0.001). In subjects with upper limb lymphedema, median value of PREV was 80.8% (interquartile range, 79.1-105.0%) in group A and 62.0% (interquartile range, 56.7-66.5%) in group B (p<0.001). In subjects with lower limb lymphedema PREV was 80.7% (interquartile range, 74.9-85.2%) and 64.5% (interquartile range, 56.0-68.1%) for groups A and B, respec- tively (p<0.001). Duration of lymphedema was found to be a strong predictive factor that may significantly impact CDT efficacy. Therapeutic effects were increased in subjects who were detected and treated earlier for lymphedema. Keywords: lymphedema, CDT, physical therapy modalities, predictive factor, rehabi- litation Lymphedema is the presence of excess interstitial fluid, high in protein due to insuf- ficient transport capacity of the lymphatic sys- tem (1). The lymphatic defect may be due to an error in lymphatic development – termed primary lymphedema, or to an acquired cause by injury to a normal lymphatic system – re- ferred to as secondary lymphedema (2). How- ever, more recent studies have shown that a lymphatic injury is only an initial event, caus- ing several subsequent changes that in some patients lead to the development of secondary lymphedema (3). Primary lymphedema is rare, while secondary type is responsible for the 99% of individuals with lymphedema; incidence of primary lymphedema is 1/100,000 as opposed to that of secondary type which is estimated at 1/1,000 (2,4,5). The prevalence of lymphedema is usually underestimated, main- ly because of the retrospective design of most studies and the fact that they rely on small- size samples (6). Regardless of classification, clinical char- acteristics include chronic swelling, localized 140 Permission granted for single print for individual use. Reproduction not permitted without permission of Journal LYMPHOLOGY.