Effectiveness of Twice-Daily Complete Decongestive Therapy in Reducing Limb Volume in Children with Lymphedema: A Retrospective Study.

Aim: To determine whether a 4-day, twice-daily complete decongestive therapy (CDT) intervention effectively reduces limb volume in pediatric patients with primary and secondary lymphedema. Methods: A retrospective cohort study was conducted using rehabilitation records of children aged 5-17 years from Camp Watchme, a North American summer camp providing lymphedema interventions. Results: Over 4 years, 38 unique campers contributed 66 records for analysis. The majority were female (68.42%), with a mean age of 9.30 ± 2.66 years. Lower extremity limb volume demonstrated statistically significant reductions across all 4 years (2021, p = 0.011; 2022, p = 0.030; 2023, p < 0.001; 2024, p < 0.001). Cumulative analysis of upper extremities (n = 16) also showed significant volume reduction (p = 0.042, r = 0.50). Daily measurement tracking (n = 43) indicated consistent percent volume decreases, with confidence intervals supporting a meaningful change for lower extremity limb volume differences across 4 years. Conclusion: An intensive, short-duration CDT intervention significantly reduces limb volume in pediatric patients with lymphedema. Future research should explore long-term effects, optimize CDT protocols, and assess broader functional and psychosocial outcomes to enhance pediatric lymphedema management.