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This systematic review appraises 12 clinical studies (2005-2019) assessing Complex Decongestive Therapy (CDT) for lower-limb lymphedema. Across heterogeneous designs, CDT consistently reduced limb volume by 20–60 %, with most benefit observed after the intensive (phase I) protocol combining manual drainage, multilayer compression, exercise and skin care. However, evidence quality was low: small cohorts, non-randomised designs and variable outcome metrics precluded meta-analysis. Durability of volume loss beyond six months and optimal maintenance strategies (phase II) remain unclear. Methodological gaps—lack of sham controls, inconsistent compression interfaces and absent lymphoscintigraphic endpoints—limit translation into precision algorithms. The authors call for multicentre RCTs that stratify by aetiology (primary vs secondary), lymphatic imaging grade and adherence to compression to clarify CDT’s long-term effectiveness and cost-utility. For clinicians, the review reaffirms CDT as first-line therapy but underscores the need for standardised protocols and patient-reported outcomes to guide shared decision-making. (pubmed.ncbi.nlm.nih.gov)
Marcelo Luiz Brandão – Pontifícia Universidade Católica de Goiás (PUC-GO), Goiânia, Brazil
Helen Pereira Dos Santos Soares – Faculdade Araguaia, Goiânia, Brazil
Maria do Amparo Andrade – Universidade Federal de Pernambuco (UFPE), Recife, Brazil
Ana Luísa Sabino de Campos Faria – Pontifícia Universidade Católica de Goiás (PUC-GO), Goiânia, Brazil
Rayza Santos Pires – Pontifícia Universidade Católica de Goiás (PUC-GO), Goiânia, Brazil
Tags: Lower Extremity; Lymphedema; Physical Therapy Modalities
