New technology has now allowed for increased assessment for this patient caseload. Lymphoedema is a condition that can cause significant swelling of the arm and hand due to excess lymph building up. This can occur when the lymphatic system, which is responsible for draining excess fluid, is damaged or altered by surgery and/or radiation therapy.  So how do we measure this swelling?

 a)      Circumferential measurements:

Historically, lymphoedema in therapy was measured mainly through circumferential measurements taken of the limbs.  This still continues and is a very beneficial way of assessing patients progress, and we use these regularly.


b)      LDex Score:

Riverina Hand Therapy has the ability to measure upper limb lymphoedema in patients using the Impedimed L-Dex machine.  We have currently been using the machine as part of our assessments for lymphoedema to measure change from therapy and also to monitor patients who have not yet developed symptoms of lymphoedema, but may be at risk. The device produces a lymphoedema index (or L-Dex) value that can help determine if patients are building up excess fluid in the at-risk arm. The test takes only minutes to perform. It is painless and gives an immediate result.


The machine gives a low electrical signal that travels through the fluid surrounding the cells which make up the muscle and tissue of the arm. The amount of this fluid increases as lymphoedema develops. Increased fluid means the electrical signal will travel more easily through the arm. An L-Dex device compares how easily the electrical signal travels in the unaffected versus the affected (or at-risk) arms and generates an L-Dex value from this comparison. The L-Dex value indicates the difference in the amount of fluid in the unaffected arm versus the affected arm.

L-Dex values are displayed against a normal “healthy” range.  L-Dex values greater than 10 or an increase of 10 L-Dex units may be indicative of lymphoedema.  L-Dex values indicative of lymphoedema should decrease as a result of therapy.

The L-Dex system is best used as a series of measurements over time. This allows us in therapy to:

        Assess early stages of lymphoedema in at-risk patients and therefore start therapy as soon as possible.

        Accurately monitor the effectiveness of therapy for those who already have lymphoedema

  If you would like to know more, please call our rooms and ask to speak to Holly or Amy.  Alternatively you can email us at This email address is being protected from spambots. You need JavaScript enabled to view it.