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THE PITTING TEST; AN INVESTIGATION OF AN UNSTANDARDIZED ASSESSMENT OF LYMPHEDEMA.
Lymphology
|May 12, 2016
Summary
The pitting test for lymphedema lacks standardization, showing wide variations in duration, pressure, and contact area among therapists. Experienced therapists use longer durations, higher pressures, and larger areas, highlighting the need for a standardized assessment procedure.
Area of Science:
- Lymphedema Management
- Clinical Assessment
- Tissue Mechanics
Background:
- Soft tissue pitting, a temporary indentation after pressure release, is used in lymphedema management.
- The pitting test's application is inconsistent and not standardized, impacting clinical reasoning.
- There is a need to investigate outcome measures for pitting identification and lymphedematous tissue characterization.
Purpose of the Study:
- To determine valid testing parameters for future studies on the lymphedema pitting test.
- To evaluate the range of pitting assessment techniques currently used by clinicians.
Main Methods:
- Six therapists with varying lymphedema experience assessed six patients with lymphedema.
- Evaluated different locations and assessed pitting using diverse techniques.
- Recorded variations in test duration, pressure, and contact area.
Main Results:
- Significant variation observed in test duration (1.1–76.0 s), pressure (1.3–14.4 N/cm²), and contact area (0.2–6.8 cm²).
- Experienced therapists used significantly longer durations (p < 0.001), higher pressures (p < 0.001), and larger contact areas (p < 0.001) compared to inexperienced therapists.
- Demonstrated the consequences of an unstandardized assessment in clinical practice.
Conclusions:
- The current clinical practice of the pitting test for lymphedema is highly unstandardized.
- Significant differences exist in assessment techniques between experienced and inexperienced therapists.
- Further research is needed to evaluate tissue response to pressure and develop a standardized pitting test procedure.
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