Workshop C includes two separate presentations covering two different topics.
Vicki Ralph
MPPA, OTR/L, CLT-LANA
Treating Orthopedic Edema
Description
Objectives
- Identify the basic anatomy and physiology of the lymphatic and venous system.
- Describe how edema can impede tissue healing and orthopedic outcomes.
- Explain why manual lymph drainage is more effective than retrograde massage.
References
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Choi I, Lee S, and Hong YK. The New Era of the Lymphatic System: No Longer Secondary to the Blood Vascular System. Cold Spring Harb Perspect Med. 2012; 2(4).
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Ebert JR1, Joss B, Jardine B, Wood DJ. Randomized trial investigating the efficacy of manual lymphatic drainage to improve early outcome after total knee arthroplasty. Arch Phys Med Rehabil. 2013 Nov; 94(11): 2103-11. Epub 2013 Jun 26.
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Foeldi M, Foeldi E, et. al (Eds in Chief). Foeldi’s Textbook of Lymphology for Physicians and Lymphedema Therapists. Urban & Fischer; 2006.
Honigman L, Ofrit B, Yarnitsky D, Sprecher E, Grnaovsky Y. Nonpainful wide-area compression inhibits experimental pain. Pain. 2016 Sep; 157(9): 2000–2011.
Hsu AF, Franceschina D, Haddad S. A novel method of postoperative wound care following total ankle arthroplasty. American Orthopaedic Foot & Ankle Society. 2014; 35(7): 719-724.
Inoue K1, Maruoka H. Effects of simplified lymph drainage on the body: in females with menopausal disorder. J Phys Ther Sci. 2017 Jan;29(1):115-118. doi: 10.1589/jpts.29.115. Epub 2017 Jan 30.
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Lee DY, et. al. The comparison of manual lymph drainage and ultrasound therapy on the leg swelling caused by wearing high heels. Technol Health Care. 2014;22(3):309-15. doi: 10.3233/THC-140785.
Lopera C, Worsley PR, Bader DL, Fenlon D. Investigating the Short-Term Effects of Manual Lymphatic Drainage and Compression Garment Therapies on Lymphatic Function Using Near- Infrared Imaging. Lymphat Res Biol. 2017 Jul 27. doi: 10.1089/lrb.2017.0001. [Epub ahead of print]
Majewski-Schrage T1, Snyder K. The effectiveness of manual lymphatic drainage in patients with orthopedic injuries. J Sport Rehabil. 2016 Feb; 25(1): 91-7. doi: 10-1123/jsr.2014-0222. Epub 2015
Miller GE, Seale J. Lymphatic clearance during compressive loading. Lymphology. 1981; 14: 161-166.
About the Presenter
Vicki Ralph holds a Bachelor’s degree in Occupational Therapy and a Master’s Degree in Public Policy Administration/Healthcare Management from the University of Wisconsin – Madison. Vicki has been an Occupational Therapist since 1982 and has a wealth of experience working in acute care hospitals, rehabilitation hospitals, skilled nursing facilities, and outpatient settings in Wisconsin, Washington D.C., Maryland, and Colorado.
Vicki received certification in Lymphedema Management in 2005, and in 2007, she successfully completed certification through the Lymphedema Association of North America (LANA). In 2011, Vicki attended an advanced lymphedema course at the world-renowned Foeldi Clinic in Germany.
Vicki relocated to Denver in 2013 and established an outpatient clinic called Edema Rehab to address lower extremity swelling challenges secondary to oncology, trauma, hereditary, and orthopedic conditions. Previously, she worked at the Adventist Rehabilitation Hospital of Maryland for over 9 years. During that time, she established and built an inpatient and outpatient lymphedema program within two hospital and outpatient clinic locations. That program has grown to employ 8 lymphedema therapists. In April 2016, Vicki joined UCHealth as a senior OT and has a goal to establish the University of Colorado Health System as a Center for Lymphatic Excellence.
Vicki has served as a course instructor for Klose Training and Consulting since 2010. She teaches both the Lymphedema Therapy Certification and Orthopedic Swelling Solutions courses all over the USA. In addition, Vicki has also traveled to Malaysia to teach both basic and advanced lymphedema therapy to health professionals in that country.
Vicki is passionate about sharing her knowledge and experience with patients, family members, and healthcare professionals. Her primary focus is geared toward teaching patients to become independent in managing swelling associated with lymphedema, surgery, trauma, and/or obesity. By decreasing swelling, patients benefit from decreased pain and improved range of motion, ADLs and mobility.
Karen Ashforth
MS, OT, CLT-LANA
The Management of Lymphostatic Fibrosis
Description
Objectives
- List five types of fibrosis associated with lymphedema.
- Identify at least three methods of upgrading current complete decongestive (CDT) practice to increase effectiveness in treating lymphedema and associated fibrosis.
References
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About the Presenter
Karen Ashforth began her career in occupational therapy in 1981 and initially worked in acute, home health, outpatient, and adult day health settings. She served as a rehabilitation clinical specialist in two of these settings and managed a multi-disciplinary staff of 16 occupational, physical, and speech therapists and social workers. Karen became Board Certified in Hand Therapy in 1993. That area of practice led her to lymphedema. She completed her lymphedema certification in 2003.
Karen’s passions in lymphedema practice are equipment innovation and development, treatment of underlying fibrosis and inflammation, and assessment of complex and difficult cases. She is considered an expert in clinical use of pneumatic compression and has participated in development of numerous devices and appliances. She currently works at St. Joseph’s Medical Center in Stockton, California, providing inpatient and outpatient lymphedema treatment. Karen also has a private consulting practice.
Karen speaks frequently at academic, clinical, and professional settings and performs clinical research that she presents and publishes nationally and internationally. Her presentations have included four International Lymphology Congress meetings: 2017 Spain, 2015 USA, 2011 Sweden, and 2009 Australia, as well as medical conferences in the United States, Canada, and Israel. She is an adjunct faculty member with the University of the Pacific in the Doctoral Physical Therapy Program.
Karen has been published in: Lymphology Journal (USA), AOTA Practice Journal (USA), OTAC Journal (USA), Pathways (Canada) and Journal of Lymphoedema (UK.)
