Single-Case Design Evaluation of Compression Therapy for Edema of the Stroke-Affected Hand

Abstract

OBJECTIVE. To explore the efficacy of low- and high-stretch compression bandaging for edema management in the stroke-affected upper limb. METHOD. A single-case, ABA-design study was conducted with 8 participants alternately allocated to receive low- or high-stretch bandaging. Edema was measured with circumferential tape at four specified points from the hand to the mid-forearm. All measurements were represented graphically for visual analysis, and celeration lines were calculated to indicate the degree of slope in each phase. RESULTS. Visual analysis indicated fluctuating edema volume in the first baseline phase, decreasing edema volume in the intervention phase, and increasing edema volume in the second baseline phase. The results did not clearly distinguish between the two bandaging groups. CONCLUSION. Compression bandaging may have benefits in the management of edema after stroke. Further research is required to identify factors contributing to the long-term maintenance of reductions gained after compression bandaging.

Handgrip exercise by the non-affected hand increases venous return in the contralateral axillary vein in patients with stroke: a pilot study

“…One of the causes of hand edema is obstructed venous return [ 4 ]. Post-stroke edema has been attributed to impaired functioning of the venous return and lymphatic system as a result of immobility [ 5 ]. Persistent hand edema is associated with pain and fibrotic tissue [ 6 ], resulting in an unfavorable effect on hand function.…”

Rehabilitation Interventions for Poststroke Hand Oedema: A Systematic Review

“…The two most common outcome measures of hand oedema are circumferential measurements and volumetric measurement (Artzberger & White, 2011). The rehabilitation management of poststroke hand oedema includes electrical stimulation (Faghri, 1997;Pandyan, Powell, Futter, Granat, & Stott, 1996), compression therapy (Bell & Muller, 2013;Gustafsson, Walter, Bower, Slaughter, & Hoyle, 2014;Roper, Redford, & Tallis, 1999), orthosis (Bürge et al, 2008;Gracies et al, 2000;Kuppens, Pijlman, Hitters, & van Heugten, 2014), and mobilization (Dirette & Hinojosa, 1994;Giudice, 1990;Kim, Lee, & Sohng, 2014). The effectiveness of contemporary therapies, such as laser therapy and acupressure, for poststroke hand oedema have also been investigated (Kang, Sok, & Kang, 2009;Karabegovi c, Kapidzi c-Durakovi c, & Ljuca, 2009).…”

Effects of proprioceptive neuromuscular facilitation stretching and deep-breathing exercises on upper extremity lymphedema in stroke patients

“…Affected-side lymphedema (LE) is a frequent aftereffect of stroke 1 ) . Although no specific etiology has been identified, immobility, impaired venous return, and paralysis of the sympathetic system are thought to promote LE.…”

“…Although no specific etiology has been identified, immobility, impaired venous return, and paralysis of the sympathetic system are thought to promote LE. LE can increase arm weight, alter appearance, and cause pain and joint contracture 1 ) . Because it hinders rehabilitation, LE therapies for stroke patients are needed.…”

“…Complex decongestive therapy effectively treats edema 2 , 3 ) , but involves the onerous daily rewinding of short-stretch bandages because pressure is not maintained. Moreover, the procedures for treating LE in the hands are inconvenient for stroke patients, because their performance requires the aid of a caretaker or therapist 1 , 4 ) . Previous studies have described the effects of deep-breathing and proprioceptive neuromuscular facilitation (PNF) stretching exercises, which can be performed unassisted, on LE.…”