Combined Decongestive Therapy (CDT) Treatment
Treatment by a certified Dr. Vodder Therapist means that a patient is receiving the best available treatment by a fully qualified practitioner. Therapists have undergone extensive training and attend updating courses to improve their knowledge. Brief descriptions of CDT treatment follow but please contact one of our therapists to find out more.
Patients undergo a medical assessment by a physician and are referred to a certified therapist. After a thorough evaluation to determine the best treatment plan, patients are advised of the treatment choices, which are customized to the individual needs.
During this Initial Phase, CDT is usually required 5 – 6 times per week and treatment may last anywhere from 2 – 4 weeks typically.
Depending on the condition, each session typically lasts one hour and involves daily assessment of the patient’s condition. Skin and wound care may be undertaken.
This is followed by Manual Lymph Drainage (hyperlink to Therapist Training-Manual Lymph Drainage). This hands-on part of the treatment usually lasts about 45 minutes and is followed by compression bandaging.
The bandages are applied exactly to conform to the patient’s tissues and are reapplied on a daily basis. They are short-stretch bandages that resist muscle contraction and are applied with comfortable padding underneath. The bandages help to maintain the reductions achieved with MLD and may even cause further reduction.
After bandaging, therapeutic exercises may be demonstrated that the patient can easily perform. These also help in further reducing the limb. Patients may join a group exercise class or be shown individual exercises.
Reduction in limb volumes vary, dependent on many factors such as age, weight, extent of the edema, skin condition and co-morbidities. Typically patients might expect a 40 – 50% reduction in limb volume although it may be more or less than this. Sometimes improvement in other measurable factors such as tissue hardness, pain and mobility may be more significant to patient than volume reduction.
Towards the end of the initial phase, volume reduction starts to stabilize and the therapist will usually recommend that the patient is fitted for a compression garment. For lymphedematous limbs, the optimal material to use for these garments is a flat knit, low-stretch material that is similar to the short-stretch bandages.
A treatment plan is devised for the maintenance phase and this may require weekly, monthly or six-monthly visits to the therapist. Patients continue to wear their compression garments, continue to do exercise and home care as well as monitor their condition carefully. MLD may also be used during these visits.
Successful maintenance of the reduced limb is essential to prevent further problems developing. With correct therapeutic intervention using CDT, patients can successfully manage their lymphedema.