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OpenTrials
Completed

NCT Number: NCT02031627

Treatment Response to Different Lymphoedema Compression Programs Using a Pneumatic Compression Device

Proof of principle study in order to determine if there is a difference in treatment effect across the 3 study groups when treating lower extremity lymphoedema using a pneumatic compression device.

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Key information

Conditions

Lower Extremity Lymphoedema Hemic and Lymphatic Diseases Leg Lymphoedema Lymphatic Diseases Lymphedema

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Royal Derby Hospital

Derby, DE22 3NE, United Kingdom

About this study

This is a single center, 3 arm, prospective, randomized, clinical trial to assess the difference between 3 treatment options for achieving a measurable physiologic effect on lower extremity lymphedema with pneumatic compression device. Each intervention arm will include 10 completed subjects for a total of 30 completed subjects.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Subjects must be ≥ 18 years old
  • Subjects must have a diagnosis of primary or secondary Stage 2 unilateral or bilateral lower extremity lymphoedema
  • Must currently be using adequate compression garment(s) as determined by the clinician: (Garments must be at least 20mmHg and no more than 3 months old and must be worn upon rising and removed at bedtime)
  • Subjects must have clinically relevant excess limb swelling as determined by clinician "pitting test"
  • Must be able to attend all required in-clinic treatment visits

Exclusion criteria

  • Diagnosis of active or recurrent cancer, or less than 3 months at the time of initial evaluation from the completion of chemotherapy, radiation therapy, or primary surgery for the treatment of cancer
  • Active infection or inflammation
  • Active thrombophlebitis (within the last 2 months)
  • History of pulmonary embolism (within the last 2 months)
  • Documented history of deep chronic venous insufficiency or deep venous obstruction with a reflux duration of > 2 second in the deep system or any history of deep vein thrombosis (DVT)
  • History of pulmonary edema
  • History of congestive heart failure
  • History of chronic kidney disease with a glomerular filtration rate (GFR) of less than 30 mls per minute
  • Poorly controlled asthma
  • Symptomatic or severe peripheral artery disease (defined by current lifestyle-limiting claudication or critical limb ischemia)
  • Presence of an open wound or ulcer of any etiology
  • Diagnosis of lipoedema and lipolymphoedema
  • Currently using an in-home pneumatic compression device
  • Metal implant(s) that would interfere with bioimpedance equipment
  • Pacemaker or other implanted electronic device(s)
  • Unable or unwilling to remove bandaging from treatment regimen while participating in the study
  • Pregnant
  • Any condition where increased venous and lymphatic return is undesirable
  • Unable or unwilling to participate in all aspects of the study protocol and/or unable to provide informed consent
  • Currently participating in another clinical trial
  • Currently using diuretics
  • BMI > 40

Treatment and study plan

pneumatic compression - 1 hour per day

Device

Pneumatic compression treatment once per day (1 hour)

Other names: Flexitouch pump, Flexitouch device

pneumatic compression - 2 hours per day

Device

pneumatic compression treatment twice per day in the AM & PM (2 hours)

Other names: Flexitouch pump, Flexitouch device

pneumatic compression - 4 hours per day

Device

pneumatic compression treatment twice per day consisting of 2 consecutive 1 hour treatments in the AM & PM (4 hours)

Other names: Flexitouch pump, Flexitouch device

Primary outcomes

  1. Limb Volume (ml)

    Time frame: Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)

    Limb volume changes measured via perometry reported in change of ml of fluid. A negative value is associated with the clinically-desirable decrease in fluid.

  2. Limb Volume (% Change)

    Time frame: Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)

    Limb volume changes measured via perometry reported in percent reduction. A negative value is associated with the clinically-desirable decrease in fluid.

  3. Change in Skin Tone

    Time frame: Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)

    Change in skin tone (fibrosis) measured via tonometry. The tonometer is a mechanical device that gives an indication of the resistance of tissue to compression. It is used in lymphedema to give an estimate of the extent of pitting and fibrotic induration. Tonometry measures were collected at 5 anatomical locations. A negative value is associated with a clinically desirable decrease in tone.

  4. Patient Reported Outcomes - MYMOP

    Time frame: Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)

    Changes in patient-determined symptoms* and change in affect the symptoms had on the subject. Measured via MYMOP (Measure Yourself Medical Outcome Profile) questionnaire. A low score indicates a good outcome. Scores range from 0 (as good as can be) to 6 (as bad as can be).

    *Recorded symptoms were: Gr A, 1st symptom: none, abdominal pain and discomfort, swelling, physical, and worrying about granddaughters Gr B, 1st symptom: arthritis, hayfever, look of fat foot, right hand area of neck and shoulder, stairs, and swelling Gr C, 1st symptom: none, energy during dancing and gardening, frustration of not going out on own, swelling, mild longstanding depression, and MPT joint at base of small toe Gr A, 2nd symptom: fatigue, heaviness of leg, mental, and pain under knee Gr B, 2nd symptom: narrowed choice of footwear, shower in bath, and swollen left foot Gr C, 2nd symptom: being tired and aching all over, and shoes and clothing

Secondary outcomes

  1. Cellular Fluid Changes (Ohms)

    Time frame: Change after initial treatment on day 1 and change baseline to end of day 5 for all groups

    Changes in extra cellular fluid (ECF) on treated leg measured by bioimpedance. A negative number is indicative of a clinically desirable reduction in ECF.

  2. Cellular Fluid Changes (% Change)

    Time frame: Change after initial treatment on day 1 and change baseline to end of day 5 for all groups

    Changes in extra cellular fluid (ECF) on treated leg measured by bioimpedance. A negative number is indicative of a clinically desirable reduction in ECF.

  3. Incidence of Complications

    Time frame: Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)

    Number of complications experienced. Incidence based on clinician assessment.

  4. Activity Level

    Time frame: Day 1 compared to final treatment day (day 12 for Group A and day 5 for Groups B and C)

    Change in number of steps as accumulated each day monitored through use of a pedometer. A positive number indicates an increase in step count (activity) while a negative number indicates a decrease in step count.

Other outcomes

  1. Change in Skin Thickness

    Time frame: Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)

    Change in skin thickness measured by ultrasound. Ultrasound measures were collected at 5 anatomical locations. A negative value is associated with a clinically desirable reduction in skin thickness (a surrogate measure of oedema).

  2. Change in Local Tissue Water (LTW)

    Time frame: Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)

    Change in local tissue water (LTW) within the skin measured by MoistureMeterD (MMD). MMD measures were collected at 5 anatomical locations using 2 probes: medium (M25) and large (L50). A negative value is associated with a clinically desirable decrease in LTW (a surrogate measure of oedema).

Sponsors and collaborators

Lead sponsor

Tactile Medical

Industry

Registry information

Official study title

Physiologic Response to Varying Lymphoedema Compression Programs With the Flexitouch System

Important dates

Study start
2013
Primary completion
2019
Study completion
2019
First posted
Jan 9, 2014
Registry last updated
Jul 20, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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