In this article LAQ Health Professional Member, Dr Amanda Pigott and Megan Trevethan, from the Occupational Therapy Department, Princess Alexandra Hospital, Brisbane look into the apps currently available as a tool for management of lymphoedema.
Many health professionals have been working remotely from their patients due to the restrictions imposed by the COVID-19 pandemic response. While this is necessary to meet our healthcare obligations, it has placed increased emphasis on the need for self-management of lymphoedema.
There are many new technologies and web platforms emerging to support self-management. The use of mobile apps is one technological approach that can support the face-to-face or telehealth treatment provided by a lymphoedema practitioner.
The use of apps has become commonplace with some health conditions, however, there are only a few apps available to support people with lymphoedema. The growth of mobile phone usage makes apps readily available to support healthcare delivery to people with lymphoedema. They present a potentially convenient and accessible method for information delivery and self-management support.
One of the challenges with app development is achieving consistent availability as there is a need to continually update programs to comply with updated software and hardware releases. This challenge has affected a number of lymphoedema apps that were previously available but are unfortunately no longer accessible.
Like all information sources, the quality and content of apps also requires review to find those which are reliable and most suitable for patients.
The review below summarises the features of some of the available lymphoedema apps. The LAQ does not endorse the use of any specific apps and this information is provided for reference only.
Some apps may have been designed for the therapist use but can also provide useful information for people with lymphoedema.
Produced by: LymphaPress
Availability: Free app available in English, Spanish, German, French and Russian versions. Available on Apple iOS via the App Store and in an Android version via Google Play
Features: Lymphatrack provides a platform for users to record lymphoedema symptoms and self-care treatments. Data can be entered daily, and the app creates graphs to monitor progress over time. Measurements are displayed graphically with one parameter per graph and can be shared with clinicians or others via email, message services or saved as a PDF. Users select the relevant parameters they wish to record from the list: limb circumference (only 2 points can be entered, location chosen by the patient), body weight, skin colour changes, pain, activity level, compression garment use, self-lymphatic drainage, pneumatic compression use, wound size, medical status change, falling incident.
Commentary: This is a simple app with easy-to-follow instructions for set-up and navigation. There is a website and a helpful PDF available for additional information if required. A limitation of the app is that only two circumference points can be entered for tracking purposes. A positive feature is the inclusion of body weight tracking allowing a patient or therapist to monitor the interaction between weight and limb circumference.
Produced by: Lymphoedema Training Academy
Availability: $33.99 available on Android via Google Play
Features: Users enter their circumferences and the app calculates a limb volume. Volume calculations are used to produce:
· distal, proximal and total volume(s) for each limb and a distal/proximal ratio
· total excess volume in ml and as a percentage relative to the other limb. Body mass index (BMI) calculations are also available.
Commentary: This is a volume measurement calculation app designed to support health professionals easily transform circumferential measurements of unilateral or bilateral limb lymphoedema into a limb volume calculation. It prompts the user to enter circumference measurements taken at 4cm increments along the limb and automatically calculates volume. The number of measurement points is not limited but must be the same for both limbs. It provides outputs for the whole limb along with isolating proximal and distal segments.
The app is useful for converting point-in-time measurements to a limb volume calculation. However, it does not store data or compare volume change over time. Nonetheless, there is a downloadable form for manual recording of measurement circumferences and volume calculations for this purpose. The app also allows for weight and height entry for quick calculation of BMI, but again does not store information for comparison over time.
Produced by: Lymphoedema Support Network, Lymphoedema Network Northern Ireland.
Availability: Free app available on Apple iOS via the App Store and Android via Google Play
Features: This is an information provision app with 4 key messages:
1. Skin care: how and why to care for skin and nails
2. Simple lymphatic drainage: arm, leg and head and neck massage sequences
3. Garment care: tips for wear and care
4. Exercises: reasons for exercises and examples of lymphatic circulation exercises
Commentary: This is a simple app with 4 key areas of information that would commonly be provided by lymphoedema practitioners. The app could be useful to reinforce individualised education provided by practitioners. The app does not have any monitoring or reporting capacity and does not allow for personalisation.
Produced by: Unknown source
Availability: Free app available on Android
Features: This is an information-only app with general information regarding:
· definition, description of disease
· signs and symptoms
· causes of secondary and primary lymphoedema
· complications, including infections and lymphangiosarcoma
· preparing for your appointment
· tests and diagnosis
· lymphoedema treatment overview
· coping support
· prevention and risk reduction practices
Commentary: This is a simple app that provides information regarding lymphoedema background, diagnosis and management. The app is limited to brief snapshots of information with no reference material or source provided. Components may be useful for simple education information or reminders of general symptom and risk reduction practices, as well as encouraging patients to be proactive in seeking information and support for lymphoedema management. Accessing the app is complicated with no direct download from Google Play. There is also no information identified regarding the app developer, with the last version updates being in 2016.
*This is an abridged version of the article published in the Australasian Lymphology Association’s Lymph Exchange August 2020.
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