Advantages And Disadvantages Of L-Deval

PATIENT EVALUATION

The patient 's primary impairments include general 3/5 strength for her upper and lower extremities, meaning that she was able to move the limb against gravity for each testing position, but was unable to maintain elevation with slight manual resistance (table 1). The patient exhibited various limitations in her passive range of motion for both upper and lower extremities, as seen in table 2. Active range of motion was used as a screening tool to determine mobility deficits, values were only obtained for passive motion. As expected, the patient had moderate flexibility limitation of the right pectoralis major secondary to the mastectomy. The left upper extremity was found to be within functional limits, so no measurements were taken. She was also found to have decreased arthrokinematic joint mobility for her glenohumeral and talocrural joints.

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This presented various disadvantages. First, we were unable to obtain a primary presurgical L-Dex value. The presurgical L-Dex value is important since it establishes a baseline by which we can determine if the patient has had an increase in bioimpedance. The normal routine for L-Dex measurement is, once before the surgery, then 1 month after the surgery, followed by an L-Dex measurement every 3 months. Her first L-Dex value was obtained on the 14th of July which was 3.5. Normal L-Dex values range from -10 to 10, this is not to say that a person with a value outside of this range is not normal. Her initial bilateral upper limb circumferential measurements did not show any significant difference as can be seen in table 3. Her LYMQOL score was 37 out of 92 at the initial evaluation, the lower the score the less difficulty she has experienced due to lymphedema. Due to similar arm circumference we would expected that her LYMQOL score would be relatively low since she did not exhibit any active signs of