The Effect of Lower Limb Lymphedema on Postural Stabilization

Abstract

ABSTRACTObjectives:Lymphedema is a chronic and serious condition thatcauses asymmetric weight dispersion between extremities. Patientscommonly report symptoms such as decreased mobility of thelimb, pain, tissue fibrosis and associated skin changes due to theswelling. These symptoms may involve postural disorders thataffect the whole body. The aim of this study was to investigatewhether there is a change in overall postural stability and limits ofstability in patients with unilateral lower limb lymphedema.Methods:Fifteen (10 female, 5 male) patients (43.2±13.08 years)diagnosed with lower limb lymphedema were included in thestudy. The mean volume difference between the two extremitieswas 548±492 ml. Lymphedema severity was evaluated andclassified as mild, moderate and severe for 2, 7 and 6 patientsrespectively. Fifteen healthy people with similar ages (43.33±8.29)were recruited for the control group. All the participants wereassessed by using the Biodex Balance System. Postural stability,which is the ability of the patient to maintain a static posturalbalance, and limit of stability, which is the ability of directionalcontrol of the body by displacing the center of gravity, wereassessed. All evaluations were carried out on a firm and stableplatform with open eyes. The data were analyzed with the SPSS21.0 program. Mann-Whitney U Test was used for intergroupcomparisons.Results:There was no significant difference between the patientsand the control group in overall, anterior-posterior andmediolateral postural stability indexes (p<0.05). However, thelymphedema group had worse overall, forward and backwardlimits of stability scores in comparison to the control group(42.33±12.5 vs 60.29±14.1; 50.73±18.6 vs 73.93±16.08;49.60±22.8 vs 67.79±21.2 respectively) (p<0.05).Conclusion:These results lead us to think that asymmetric fluiddistribution in the lower body parts deteriorate directional control in patients with unilateral lymphedema in comparison to thehealthy group. Further studies are needed to confirm the changesof postural stability and limits of stability in these patients.Abbreviations: BW = body weight, CoG = center of gravity, LLL = lower limb lymphedema, LoS = limits of stability, PoS = postural stabilityKeywords:Unilateral Lower Limb Lymphedema, Biodex BalanceSystem, Postural Stability