Physical Medicine & Rehabilitation

Biography

Biography: Yvonne Eschke

Abstract

In addition to the blood circulation the lymphatic system transports liquids from the interstitial tissue into the blood vessels and supports and backs up the veins in transporting liquids from peripheral to central regions. According to Starling's hypothesis there should be an equilibrium in microcirculation between filtration and reabsorption. But in orthostasis and in tissues like musculature and skin for example the reabsorption is entirely done by the initial lymphatic vessels. The liquids have to pass the lymphatics on their way to the veins (Schad 1996, 1998). This is another key function of the lymphatic system apart from the well known cardinal function of protein transport. The lymphatics have to compensate what the veins cannot cope (in physiologic as in pathologic situations). If this capacity is exceeded a swelling because of a high-volume insufficiency as well as a combined insufficiency appears in the tissue. In case of a combined insufficiency, stimulating the activity of the lymph vessels can therefore accelerate the healing of wounds and inflammatory processes which are accompanied by a protein rich edema. This acceleration is reached by CDT. Complex Decongestive Therapy combines manual lymphatic drainage with skin care, compression with decongestive lymphatic bandage and physical exercise. The Manual lymphatic drainage and compression is not only used to treat primary and secondary lymph edemas but also the wide spread edemas of inactivity and immobilization, the post surgery and post traumatic edemas even in sport physiotherapy, and the phlebological edemas. The possible results of therapy can be shown in several case reports. The description of the pathophysiology is followed by a demonstration of the very soft strokes of Manual lymphatic drainage (Vodder Method) and by the demonstration of the essential multi-layer