Manual edema mobilization techniques should be considered in conjunction with conventional therapies, in cases of. The lymph system alone is responsible for removing large proteins and excess fluid from interstitial tissues, and works in tandem with the circulatory system. She is able to care for those with acute operative or nonoperative needs and chronic conditions. Manual therapy techniques consist of, but are not limited to, connective tissue massage, joint mobilization and manipulation, manual traction, passive range of motion, soft tissue mobilization and manipulation, and therapeutic massage. Manual edema mobilization associates mema home facebook. Mem includes deep belly breathing, light lymphatic selfmassage, exercise and light. Manual edema mobilization mem is a lymphatic stimulation technique used for recalcitrant subacute or chronic limbhand edema in the orthopedic population. Pressure pain threshold, as a measure of somatosensory function, is a wellapplied measurement technique for the pain perception in koa. Edema control and physical agent modalities flashcards. The aim of this study was to look at the effect of the emphasis on selfmanual lymph drainage as part of a home program, to determine the efficacy of such an intervention when the number of clinic visits were reduced. An association of therapeutic techniques, usually including manual or. A volumetric evaluation is necessary to quantify the edema and to evaluate.
Feldscher ot, cht 39 2015 1 edema management sheri b. The positive effect of different manual mobilizations have been proven in the management of knee osteoarthritis koa. This volume focuses on the underlying biomechanics and fundamentals of thrust and nonthrust manual joint treatment techniques for the extremities. Gait training, pain and edema control, and muscle stimulation to improve quadriceps recruitment.
Explain the general and applied concepts of peripheral joint mobilization. Integrating manual edema mobilization within the nicu for optimal. Lower extremity edema management exercises supine, page 2 x30527bc rev. Feldscher ot, cht anatomy and physiology lymphatic system scavenger system removes excessfluid,debris, and other materials from the tissue spaces alternate pathway to the heart forsubstances toolargetobe. Manual edema mobilisation mem edema is defined as an accumulation of excessive fluid in intercellular spaces.
Oedema is glue, a phrase popularized by watsonjones in 1941, sums up the importance of reducing edema in swollen hands. Manual edema mobilization courses sandra artzbergers workshop teaching schedule. This manual serves as an introduction to lymphedema therapy and outlines the basic manual techniques to assist in managing edema. The effect of mechanical massage on early outcome after total. Explain the physiological and psychological responses to specific massage techniques. Coding and billing massage therapy 97124 and manual therapy 97140 when should manual muscle work be described as massage therapy, and when should it be described as manual therapy. He joined the staff at uwm in november 2012 teaching the comprehensive lymphedema and venous edema management course, lymphedema 2.
Discover the practical foundations of joint mobilization for extremities in this updated 8 th edition of freddy kaltenborns classic book. Mobilization of fluids in the intensive treatment of primary and. Skilled in the custom fabrication of orthoses for the upper extremity, wound care, manual edema mobilization and rehabilitation for tendonitis and nerve impingements. Knee edema is a normal body response to surgical trauma and occurs in most patients who undergo tka, 14. Edema classifications and their relationship to manual edema mobilization 2002. The use of manual edema mobilization for the reduction of persistent edema in the upper limb. The effect of additional ankle and midfoot mobilizations. Edema management light compression with coban or compression sleeves to digits, hand and forearm as needed elevation manual edema mobilization mem scar management begin scar massage no sooner than 2 days after suture removal after scar is fully closed with no scabbing present. She is simply one of the best teachers ive had the privilege of learning from, and. The use of manual edema mobilization for the reduction of.
Manual edema mobilisation mem 24012014 by tech edema is defined as an accumulation of excessive fluid in intercellular spaces. Edema is defined as an accumulation of excessive fluid in intercellular spaces. Neurodynamic mobilization and peripheral nerve regeneration. Manual edema mobilization associates mema is the consortium of therapists selected and authorized by sandy artzberger, ms, ot, cht, clt to. Iceelevation every 2 hours for 15 minutes to minimize edema and promote healing please refer to icing handout. It is a natural byproduct of the healing process that changes as an injury advances through the stages of healing. Manual edema mobilization manual edema mobilization. Effectiveness of edema management techniques for subacute hand. Manual therapy techniques fall 2015 technical college of. Hand therapy goaldirected treatment techniques quizlet. Jun 14, 2018 massage therapy can be beneficial in local causes of edema. Soft tissue treatment to quads, posterior musculature, suprapatellar pouch, popliteal fossa, iliotibial band and hoffas fat pad.
Neural mobilization is a multidimensional treatment approach that has gained popularity because it is effective, and easy to implement. Sandra artzberger ms otr cht clt is both a clinician and lecturer in the fields of hand therapy, upper and lower extremity edema and lymphedema treatment. The use of manual edema mobilization for the reduction of persistent. Heel pain is a common phenomenon, occurring in approximately 10% of the population over a lifetime, 7, 10, 28 and the leading cause of treatment for foot and ankle pathologies.
Atlantic orthopaedic specialists physical therapy aospt now. Responsibilities include patient and family education, team. Effectiveness of edema management techniques for subacute hand edema. Manual lymphatic drainage is the application of light, flowing strokes of massage in specific patterns with the goal of alleviating lymph edema after lymph node resection or radiation therapy. It is not intended to replace the advice of your health care provider. Manual edema mobilization techniques should be considered in conjunction. Decreasing or managing edema, especially in the sub acute or chronic stage, is of great. Management of a complex stiff hand diane coker, pt, cht, dpt whats involved. Edema control instructions for patients clinicians. The next level, lymphedema 3, manual edema mobilization, mfr, and deep tissue injury rehab courses and dry needling. Changes in pain, swelling, and range of motion according to. Her research interests involve hand rehabilitation topics such as orthotics, chronic pain, manual edema mobilization, and occupationbased practice.
Continuing education presentations for mem presentations check page listing 20172019 continuing education presentations or contact individual mem instructorssee page of endorsed mem instructors. Orthopedic manual therapy for the pediatric patient. Case report the use of manual edema mobilization for the reduction of persistent edema in the upper limb susan boiselle howard, otrl, cht clinicalinstructor department of occupational therapy virginia commonwealth university. Karen applebey kalamazoo, michigan area professional. Doctorate degree in physical therapy, southwest baptist university, 2015. Creating a paradigm shift in swelling management manual edema mobilization associates offers trainings and resources for providers to improve patients lives with manual edema mobilization mem techniques. Onlocation trainings are facilitated by endorsed mem instructors. Manual edema mobilization mem is a method of edema reduction based on the lymphatic systems. Integrating manual edema mobilization within the nicu for. Cpt position on the proper use of procedure code 97140. Manual lymphatic drainage an overview sciencedirect topics.
Treatments at hand works occupational therapy we utilize a wide variety of evidence based treatment modalities to produce the best possible outcome for our patients. For adults with nonspecific shoulder pain of variable duration, cervicothoracic spinal manipulation and mobilization, in addition to usual care may improve selfperceived recovery. There is low to moderate quality evidence with limited confidence in the effect estimate to support the use of manual edema mobilization methods in conjunction with standard therapy to reduce problematic hand edema. To compare two techniques in reducing edema, 30 patients with subacute handarm edema after a distal radius fracture were randomized to either receive modified manual edema mobilization mem approach or traditional edema treatment.
Management of persistent edema with the common treatment methods reported in the literature is not always successful. Manual edema mobilization mem is a relatively new treatment regimen derived from established european and australian lymphedema reduction regimens. Manual edema mobilization which is used in cases where the impairment of lymph system is temporary edema rather than caused by damage to the lymphatic. A howto video demonstrating some of the techniques used in manual edema mobilization mem. The aim of this study was to look at the effect of the emphasis on self manual lymph drainage as part of a home program, to determine the efficacy of such an intervention when the number of clinic visits were reduced. Manual therapy techniques in lymphedema treatment 11 time frame was needed to achieve these results8 weeks versus 4 weeks. It includes the use of exercises, light skintractioning massage techniques following the lymphatic pathways, and the use of lowcompression garments. Manual edema mobilization techniques should be considered in conjunction with conventional therapies, in cases of excessive edema or when the edema has not responded to conventional treatment alone. Mem is a specific technique with biologic rationale designed to reduce subacute and chronic edema. These maneuvers can be performed in a passive manner where a therapist guides the client through a movement pattern, it can also be carried out as part of a selfcare program that clients perform on their own. Subjects and methods eighteen patients with knee edema following total knee arthroplasty were randomly assigned. Manual lymphatic drainage mld skin mobilization technique that is designed to. Dec 26, 2015 the subjects consisted of 20 elderly patients, 6575 years old, who had concomitant pain and edema, and were hospitalized to undergo tka at eulji general hospital in nowon district of seoul, south korea, between may 4 and june 26, 2015.
Manual edema mobilization mem is not indicated for all hand patients but can be highly effective in cases of recalcitrant subacute or chronic edema. Select appropriate manual therapy techniques based on the poc, diagnosis, and signssymptoms. Define terms related to soft tissue manual therapy massage 3. This manual does not provide lymphedema therapy certification or specific information on compression wrapping and garments. Pdf neurodynamic mobilization and peripheral nerve. Massage therapy can be beneficial in local causes of edema. Verbal instructions often are forgotten or misunderstood. Jul 04, 2015 this feature is not available right now.
A randomized clinical controlled study comparing the effect of modified manual edema mobilization treatment with traditional edema technique in patients with a fracture of the distal radius 2011. The phrase popularized by watsonjones in 1941, oedema is glue, summarizes the importance of reducing edema in swollen hands because persistent edema can contribute to fibrosis, stiffness, and limited range of motion rom. Using a multilayered approach addressing the physical, mentalemotional, and energetic principals of healing, you will learn the tools to promote tissue. Bs degree in exercise science, old dominion university, 2010. After 9 weeks, both treatments had the same results in active range of motion arom, pain, and activities of daily living adl and edema reduction. Nov 30, 2015 purpose the aim of this study was to evaluate the efficacy of mechanical massage via endermologie after total knee arthroplasty in reducing edema and pain and improving knee range of motion, in the early postoperative period. Decreasing or managing edema, especially in the sub acute or chronic stage, is of great importance to the therapists at hand works occupational therapy. It may be reasonable and necessary as an adjunct to therapeutic exercises when loss of articular motion and flexibility impedes the. Manual edema mobilisation mem hand works occupational. Clinicianiii hand therapist hand management center medical college of virginia hospitals richmond, virginia sheama krishnagiri, phd, otrl associate professor department. The effect of additional ankle and midfoot mobilizations on. Priganc is developing the university of vermont s occupational therapy program.
Identify additional positioning strategies for edema management for infants with congenital diaphragmatic hernia, congenital chylothorax, spinal muscle atrophy, and limb anomalies. There are currently, 1 guests and 0 members that are online. If youve never had the pleasure of learning from holly schifsky, please consider doing so. Darrell becker, ma, pt director bs degree in physical therapy, vcu medical college of virginia, 1986 ma degree in exercise physiology, university of maryland, 1981 orthopaedic experience 1986. He is invested in this education due to both personal and professional reasons. Postoperative patient instructions should be simple, provide focused information, and ideally be understood regardless of the native language of the patient. There is low to moderate quality evidence with limited confidence in the effect estimate to support the use of manual edema mobilization methods in conjunction with standard therapy to reduce. The purpose of this course is to teach therapists the lymphatic decongestion method of mem for the lower extremities. This article explains in laymans terms about lymphatic massage therapy for edema and its benefits in many conditions including stressstrain, swelling, breast cancer, etc. Modified manual edema mobilization treatment needs fewer sessions. Rehabilitation and disability critically appraised papers. Manual edema mobilization mem is a hammer every therapist should have in their treatment tool box.
Mubaraka attarwala occupational therapist community. Bialosky je, bishop md, price dd, robinson me, george sz. Feldscher ot, cht anatomy and physiology lymphatic system scavenger system removes excessfluid,debris, and other materials from the tissue spaces alternate pathway to the heart forsubstances toolargetobe disposed of through the venous system. Manual edema mobilisation mem hand works occupational therapy. Integrating manual edema mobilization within the nicu for optimal neuromotor development. Infants born prematurely have a high incidence of chronic lung disease and gastro esophageal reflux disease. Orthopedic manual therapy for the pediatric patient mitchell selhorst, dpt, ocs. Jul 23, 2015 exercise instructions for manual oedema mobilisation to address oedema in the upper limb. Subjects and methods eighteen patients with knee edema following total knee arthroplasty were randomly assigned to the intervention group n8 or the control. The effect of mechanical massage on early outcome after. Effectiveness of edema management techniques for subacute. Manual edema mobilization which is used in cases where the impairment of lymph system is temporary edema rather than caused by damage to the lymphatic system lymphedema. Stroking is applied in centripetal directionmassage should be performed with the extremity elevated retrograde massage and manual edema mobilization are contraindicated when cardiac edema is present.
Manual edema mobilization and lymphedema patient self management cards computer cards 2007 from. Mem approach and compare it with a traditional edema technique. Demonstrate fluid mobilization techniques to utilize with infants for the trunk, upper and lower extremities. Contact your health care provider if you believe you have a health problem. She has also been active throughout her career with the american society of hand therapists. Effleurage for edema, soft tissue mobilization to surrounding tissues, gentle range of motion.
Coding and billing massage therapy 97124 and manual. The consequences of knee edema are pain, inflammation, decreased range of motion, quadriceps inhibition, functional limitation and a delay in rehabilitation, 15. Manual therapies joseph quade, physical therapist, of great lakes therapy provides a comprehensive treatment approach for your physical therapy needs, covering acute injury and chronic pain. International clinical trials registry platform from inception to august 2015. Edema reduction for sub acute handarm edema based on mem pump point. The cpt position on the use of procedure code 97140 for manual therapy techniques states the following.