A review of outcome indicators in the treatment of chronic limb oedema

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Abstract
Objectives: To provide an overview of physical and psychological outcome indicators which have been used to evaluate conservative treatments for chronic oedema. Methods of finding papers: Papers were located via the MedLine, CINAHL and GEARS databases, and the British Lymphology Interest Group Key References lists. Issues reviewed: The literature reveals that only a small amount of work has addressed conceptual issues in outcome evaluation. Above all, outcome indicators have been adopted in clinical practice in a haphazard manner, with little discussion regarding the purpose of outcome assessment/measurement and little agreement on the most appropriate assessment/measurement techniques. Results: Eleven outcome indicators appear in the literature, each of which is discussed in terms of instrumentation and application in clinical practice. Practitioners have focused on objective measures, with change in limb volume the outcome measure most commonly used. Conclusion: It is concluded that more rigour is needed in many aspects of outcome evaluation. Practitioners and researchers in this field should become more questioning of existing evaluation practices, and should explore the many potential outcome indicators, such as limb movement and limb function, which have to date been neglected.