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Delphi study on the STRIDE algorithm for compression selection in upper-body lymphoedema.

Karen J Bock¹, Suzie Ehmann², Naomi Dolgoy³

¹Assistant Professor, Rockhurst University, Kansas City, MO, USA.

Journal of Wound Care

|November 11, 2025

Summary

This summary is machine-generated.

The updated STRIDE algorithm now guides compression garment selection for upper body lymphoedema, including the arm, breast, and trunk. This consensus-based revision enhances treatment for these conditions.

Keywords:

Clinical expert panel Complete decongestive therapy Complexity-informed research Compression garment selection Delphi consensus method Evidence-based practice International guideline development Patient–clinician partnership Quality of life outcomes Upper-body lymphoedema

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Area of Science:

Lymphedema management
Compression therapy
Clinical algorithm development

Background:

The original STRIDE algorithm focused on lower-limb lymphoedema.
Upper body lymphoedema (arm, breast, trunk) management requires specific guidance.
Existing algorithms did not adequately address upper body lymphoedema treatment.

Purpose of the Study:

To update the STRIDE algorithm for compression selection in upper limb, breast, and trunk lymphoedema.
To achieve expert consensus on the definitions and importance of the six key aspects of the STRIDE algorithm.
To provide a framework for clinical decision-making in upper body lymphoedema management.

Main Methods:

Modified Delphi framework utilized for expert consensus.
Two rounds of surveys administered to clinical experts globally.
A >70% agreement threshold was established for consensus.

Main Results:

Consensus was reached on the definitions of all elements of the revised STRIDE algorithm.
Shape and issues were prioritized in compression selection, while refill was considered least often.
The revised algorithm achieved >70% agreement among international experts.

Conclusions:

Consensus was achieved on the revised STRIDE algorithm for upper body lymphoedema compression.
The updated STRIDE algorithm facilitates clinical decision-making for upper limb, breast, and trunk lymphoedema.
This provides a standardized approach to selecting compression garments for the upper body.