September’s Research Roundtable explored Modified Decongestive Therapy (MDT), an approach being studied by Mayo Clinic occupational therapist and lymphedema specialist Rachel Alonzo.
Complete Decongestive Therapy (CDT) remains the gold standard for lymphedema treatment, but access can be challenging due to limited insurance coverage, shortages of trained therapists, geographic barriers and the intensity of traditional treatment. Alonzo’s research asks: Can we preserve the essential elements of CDT while making treatment more accessible and patient-directed?
MDT emphasizes self-management. Patients learn lymphatic exercises and self-manual lymphatic drainage (MLD), with compression introduced as appropriate. Pneumatic compression may also be incorporated. Instead of intensive daily appointments, patients return periodically for reassessment, hands-on treatment and adjustments to their home program.
Early results are encouraging. Patients in Alonzo’s study have demonstrated at least a 10% reduction in limb volume over approximately three to five months, along with improvements in quality of life. While MDT generally takes longer to achieve results than traditional CDT, it may require fewer clinic visits and make treatment more feasible for patients who have difficulty accessing specialized care.
Three components remain central: lymphatic drainage, compression and movement/exercise. Alonzo emphasized that MDT is not intended to replace CDT. Instead, it offers another option—one built around partnership, flexibility and helping patients successfully manage their condition at home.
The takeaway? Effective lymphedema care isn’t simply about prescribing the ideal treatment plan. It’s about creating a plan patients can realistically sustain—and empowering them to become active participants in their own care.
Special thanks to Karen Ashforth, MS, OTR, CLT-LANA, who moderated the discussion.
