Supportive Care in Cancer

, Volume 27, Issue 3, pp 959–963 | Cite as

Variability in compression pressure of multi-layer bandaging applied by lymphedema therapists

  • Hisako Hara
  • Nobumitsu Hamanaka
  • Maki Yoshida
  • Noriko Ikehata
  • Shigeko Tachibana
  • Katsura Nakakawaji
  • Makoto MiharaEmail author
Original Article



The success in multi-layer bandaging (MLB) relies on the technique of the therapists. The purpose of this study was to elucidate the compression pressure of MLB by lymphedema therapists.


We investigated the pressure of MLB applied by 48 lymphedema therapists. The average age was 43.5 (range 23–66) years old. Seventeen (35.4%) of the therapists had the clinical experience of MLB. We prepared ordinary compression materials and asked them to apply MLB to the whole lower limb of healthy volunteers, presuming moderate lymphedema. We attached the probe of Picopress at the Achilles tendon-muscle junction and measured the pressure three times: phase 1, resting condition; phase 2, after ankle exercise; and phase 3, after knee bend.


The average pressure in phases 1–3 was 51.9, 48.9, and 45.5 mmHg, respectively. Only 13 (27.1%) of the therapists achieved 50–59 mmHg which is suitable for lymphedema treatment and the pressure varied by the training courses. The pressure decreased as the blank period got longer after finishing training courses (R = − 0.39).


The pressure of MLB varied in different therapists and different training courses. This fact indicated the necessity of uniform curriculum in training courses including measurement of the bandaging pressure.


Lymphedema Complete decongestive therapy CDT Bandaging Pressure Multi-layer bandaging 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest. We agree to allow the journal to review the data in this study if requested.

Supplementary material

520_2018_4385_MOESM1_ESM.xlsx (13 kb)
ESM 1 (XLSX 12 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Hisako Hara
    • 1
    • 2
  • Nobumitsu Hamanaka
    • 2
  • Maki Yoshida
    • 2
  • Noriko Ikehata
    • 2
  • Shigeko Tachibana
    • 2
  • Katsura Nakakawaji
    • 2
  • Makoto Mihara
    • 1
    • 2
    Email author
  1. 1.Department of Lymphatic and Reconstructive SurgeryJR Tokyo General HospitalTokyoJapan
  2. 2.Bethel South Shinjuku ClinicTokyoJapan

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