Lymphedema Certification and Online Education

LLIS and Impairment Score Calculator

LLIS Version 2

Validation and Application of the Lymphedema Life Impact Scale (LLIS):
A Condition-Specific Measurement Tool for Persons with Lymphedema

developed by Jan Weiss, PT, DHS, CLT-LANA

Lymphedema is a condition manifesting as swelling when the lymphatic system fails to successfully remove excess tissue interstitial fluid. It may result from varying etiologies, but commonly is associated with cancer treatment. Numerous impairments and activity limitations associated with lymphedema have been shown to adversely affect quality of life. Most literature reporting the effects of lymphedema on quality of life have utilized either generic quality of life (QOL) instruments or cancer-related outcome measures. The difficulty in using those measures is the lack of sensitivity to issues relating to lymphedema. Due to the specific impact of lymphedema, it is important to use a condition-specific measure to assess the effects of all kinds of lymphedema upon patients, and on which to plan and base appropriate treatment. Several condition-specific functional or health-related quality of life questionnaires have been reported in lymphedema research in recent years; however most are designed to measure only upper limb lymphedema following breast cancer. Few patient-reported outcome-measuring instruments exist to measure the impact of all-type and any extremity lymphedema. Although there has long been a recognized need for better outcome reporting for patients with lymphedema, there has remained a dearth of good condition-specific outcome measures.

The Centers for Medicare and Medicaid Services in the U.S. implemented a requirement in 2013 for documentation of functional outcomes, impairment categorization, and severity (G-codes) for rehabilitation. This necessitated the need for a comprehensive instrument for all-types and any extremity lymphedema and a means by which severity of condition could be established. The Lymphedema Life Impact Scale (LLIS) was developed by a LANA-Certified Lymphedema Therapist as a comprehensive lymphedema-specific instrument to measure impairments, activity limitations, and participation restrictions in those living with any extremity lymphedema. This 18-question assessment tool includes physical, psychosocial, and functional domains. Further, it is designed to work in conjunction with an impairment calculator to assist in determination of impairment severity. Both the LLIS and accompanying Impairment Score Calculator are available at no cost through Klose Training.

To read the full published article, please click the title below:
Validation of the Lymphedema Life Impact Scale (LLIS):
A Condition-Specific Measurement Tool for Persons with Lymphedema