Challenges of lymphoedema management in an ageing population.

The risk of developing chronic oedema increases with age. Many factors affect the successful management of this condition, which a robust holistic assessment will identify. This article discusses some of the challenges and complications associated with managing this long-term condition, alongside comorbidities and the effects of ageing. It will consider the implications of wider issues such as social care and the current healthcare economy. The challenges of lymphoedema management can be overcome by offering a collaborative approach to care. This can be achieved by specialist practitioners offering support, advice and guidance on how to ensure satisfactory outcomes for patients in a timely manner.

Mobiderm Autofit: an adjustable sleeve that enables patients to self-manage lymphoedema.

Lymphoedema can result in debilitating physical and psychosocial morbidity and when combined with other chronic comorbidity, often requires holistic, specialist management that encompasses all the complex and compounding problems. Self-care is an integral component of any treatment strategy, however, the patient must be fully prepared and ongoing support should be provided. Self-care consists of managing the symptoms of lymphoedema but should include other fundamental aspects of healthy living, for example, maintaining a healthy weight and activity levels. To improve self-care, compression manufacturers have been instrumental in designing new ways of applying compression. Mobiderm Autofit armsleeves have been designed to improve the donning and wearing of compression sleeves in all patients. This product is especially useful for night-time wear and in the presence of fragile skin, or for those who only require reduced compression. The benefits of this garment are demonstrated in three case studies.

Managing upper limb lymphoedema with use of a combined armsleeve compression garment.

This article will detail the findings of 4 case studies following a product evaluation of a JOBST Bella Lite combined armsleeve for mild to moderate lymphoedema, while discussing the assessment and management of upper limb lymphoedema. Holistic assessment and consideration of psychosocial impact on the patient will be discussed briefly along with guidance on how to determine those 'at risk' of developing the condition.

Functional optical topography analysis using statistical parametric mapping (SPM) methodology with and without physiological confounds.

Functional optical topography (OT) measures the changes in oxygenated and deoxygenated hemoglobin (HbO(2), HHb) across multiple brain sites which occur in response to neuronal activation of the cerebral cortex. However, identification of areas of cortical activation is a complex task due to intrinsic physiological noise and systemic interference and careful statistical analysis is therefore required. A total of 10 young healthy adults were studied. The activation paradigm comprised of anagrams followed by finger tapping. 12 channels of the OT system were positioned over the frontal cortex and 12 channels over the motor cortex while the systemic physiology (mean blood pressure (MBP), heart rate (HR), scalp flux) was simultaneously monitored. Analysis was done using the functional Optical Signal Analysis (fOSA) software and Statistical Parametric Mapping (SPM), where we utilized two approaches: (i) using only HbO(2) as a regressor in the general linear model (GLM) and (ii) using all of the explanatory variables (HbO(2), MBP, HR and scalp flux) as regressors. Group analysis using SPM showed significant correlation in a large number of OT channels between HbO(2) and systemic regressors; however no differences in activation areas were seen between the two approaches.