Effectiveness of edema management techniques for subacute hand edema: A systematic review.
Leanne K Miller, Christina Jerosch-Herold, Lee Shepstone
PMID 28807598WHAT IT FOUND
For subacute hand edema after trauma, surgery, or stroke, evidence is low to moderate and mixed.
Adding manual edema mobilization to elevation, exercise, and compression may help troublesome swelling, but no particular technique is proven.
Key findings
01The review found limited low to moderate quality evidence supporting manual edema mobilization for problematic subacute hand edema compared with standard treatment alone.
02Manual edema mobilization combined massage, exercises, pump point stimulation, home exercise, and low stretch bandaging, and conventional therapy included elevation, exercise, and compression, so the contribution of any component cannot be separated.
03Adding kinesiology tape to standard occupational therapy, physical therapy, and speech and language therapy did not show a significant difference in MCPJ or wrist circumference change.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The included studies were low to moderate quality, with poor reporting of methods and interventions. Many studies measured edema immediately after treatment or only for a short time, so long term effects were unclear. Interventions were often combined, and standard therapy was not described in enough detail, so the effect of any component could not be isolated. The review could not combine results for meta-analysis because interventions, outcomes, and reporting methods varied. Some trials had small samples, limited blinding, or no independent assessors.
The easy way to misread this
Do not read this review as evidence that a particular hand edema technique works. The evidence was low to moderate, treatments were often combined, and follow up was short, so no particular method can be considered proven.