Concurrent and breakfast sessions

Friday 14 May 2021

Session 1A: Turnabout training

Jane Wigg, Lymphoedema Training Academy

The first step to a beautiful life is raising consciousness. This symposium is open to everyone and anyone. This training will increase the awareness of yourself believing limitations and those of our clients. I promise you that this training will change your life immediately-for the better. Will you be open to taking that chance? We will investigate together the chatter that goes on in your head. You will have heard it, you might answer it, obey it, believe it or if you are lucky ignore it. I will help to you help yourself and in turn, this will help many others. We often discuss our patients lack of concordance and choices they make. What's stopping them, maybe what's spotting us too. This introductory training will not fix you because you were never broken but it will provide the tools to help you focus, become conscious, to be kind to yourself and find the real you.  

Session 1B: Practical aspects involved in lipoedema differential diagnosis 

Helen Eason, Physiotherapy, PhD Candidate University of Sydney

Research into various aspects of lipoedema has gathered momentum in recent years enhancing the lymphologists knowledge of the lipoedema phenotype and therefore changing the way lipoedema is assessed and treated.
There has never been a more pertinent time to update your knowledge regarding the innovations in diagnostic tools and assessment techniques that are occurring which are improving diagnosis, management and quality of life for lipoedema sufferers. This practical workshop, involving lipoedema patients, is suitable for all health professionals involved in working with lipoedema clients. The workshop aims to improve lipoedema assessment and differential diagnosis skills. A basic knowledge of lipoedema pathophysiology is required.
Learning outcomes -
• A summary of recent research findings into pathogenesis of lipoedema 
• Defining the lipoedema phenotypes and how to assess them 
• Practical session on objective assessment with lipoedema patient involvement 
• Differential diagnosis from obesity, Dercum’s disease and other fat disorders. 

Session 1C: Implementing a prospective surveillance and early intervention model of care for breast cancer related lymphoedema into clinical practice  

Louise Koelmeyer, Director, ALERT Program, Macquarie University

Despite national guidelines and evidence-based research supporting a prospective surveillance and early intervention model of care for breast cancer related-lymphoedema, bridging the gap between research and clinical practice has been difficult. Understanding the process of translating effective interventions into standard care practice is important for improving uptake and sustainability. Implementation science aims to facilitate the translation of clinically efficacious interventions into practice. The use of the RE-AIM framework to evaluate implementation effectiveness acknowledges the importance of other factors that influence the value of an intervention in real-world settings. The RE-AIM framework consists of five dimensions: Reach, Effectiveness, Adoption, Implementation and Maintenance. At the conclusion of this workshop attendees will be able to: Describe the clinical and governance literature that support a prospective surveillance and early intervention model of care in breast cancer, Describe how bioimpedance spectroscopy can aid in the early detection of breast cancer related lymphoedema, Describe the components of a prospective surveillance and early intervention model of care, Describe how to implement the prospective surveillance and early intervention model of care using the RE-AIM framework across public and private health systems, Describe barriers to implementing the prospective surveillance and early intervention model of care.

Session 1D: SIGVARIS custom made flatknit measuring workshop   

Susan Butcher, Clincial Manager, SIGVARIS GROUP and Kim Parageter, Fitting Consultant, SIGVARIS GROUP

Sponsored by SIGVARIS GROUP

SIGVARIS Custom made flatknit measuring workshop With the launch of our Custom made flatknit range OPTIform & OPTIflex we will be presenting a workshop in measuring and fitting our SIGVARIS/flatknit custom garment range. This 3 hour workshop aims to enhance therapist understanding of compression while developing skills in measuring large unshapely limbs. A presentation showing patient case history of garment use with recent outcomes will be discussed. This will be a comprehensive and interactive/hands on workshop focusing on correct measuring/fitting, while perfecting your troubleshooting garment skills. Susan is a trained Lymphoedema Therapist. Working mostly with large shaped limbs both with Lymphoedema and Lipoedema patients. Kim has measured/fitted may difficult shape limbs, in her role as fitting consultant for sigvaris. Many therapists and nurses in Victoria welcoming a phone call from her.

Session 1E: Is it just a matter of size? Understanding compression and obesity

Rosemary Kendell & Veronica Eichmann, Clinical Representatives 

Sponsored by Jobskin Australia

2 in 3 adults overweight or obese. 1 in 4 children overweight or obese. 1 in 3 adults obese. These are the 2017-2018 stats(1). Obesity is an increasing feature in the health landscape with an even greater representation in the population treated by lymphoedema therapists. Compression is one of the cornerstones of lymphoedema, lipoedema and vascular management, but do we really understand all of the complexities of using compression on larger bodies? This workshop, presented by Jobskin, will review the evidence and literature concerning compression and obesity, then will troubleshoot some of the challenges that larger bodies present with the prescription and design of effective compression garments. This workshop will include case studies and will provide you with the opportunity to hone your measuring skills with challenging body shapes. (1) Australian Institute for Health and Weight (Australian Government).

Session 2A: Lymphoedema surgery - The basics

Associate Professor Ramin Shayan, Consultant Plastic Surgeon, Alfred Health, Brighton Plastic Surgery, Royal Melbourne Hospital, St Vincent’s Hospital Melbourne, VPSU

Director, O’Brien Institute Department, St Vincent’s Institute of Medical Research

Understanding Lymphoedema surgery techniques, when to refer and before and after care.

Session 2B: Laser therapy and lymphoedema:Theory and practice 

Sharon Tilley and Catherine Norton

Sponsored by Heal with Laser

How does Laser Therapy help with lymphoedema? In a clinical study at the ASAcampus Joint Laboratory, researchers found that a dual wavelength MLS laser (808 nm and 905 nm) significantly reduced both the extracellular fluid and total volume of the affected arm, inducing fibrosis softening and improving heaviness, aching and tightness. They went a step further to show that high power laser did not affect the behavior of human dermal fibroblasts and breast adenocarcinoma cell lines in terms of proliferation, cell cycle progression, apoptosis and cloning efficiency. These results show the safety of using the MLS Laser as a lymphoedema treatment because the treatment did not induce an increase in tumor cell growth.
Benefits of Using Laser therapy to treat lymphoedema. There are proven advantages to using the MLS Laser for treating symptoms of lymphoedema.
1.     It increases the flow of lymph and improves surgical scars - MLS Laser Therapy softens the fibrotic tissue and simulates poorly functioning lymph vessels. The light of the laser increases the flow of lymph, reduces the amount of excess protein and tissue in the field, and reduces the ability of the scar tissue to stick to the underlying healthy tissue. The increase in lymphatic mobility after receiving laser therapy may help remove stagnant tissue fluid in lymphoedema and reduce the volume of a lymphedematous area such as arm or leg. Laser therapy has also been reported to remove surgical scars by preserving normal tissue architecture.
2.     It is painless - With the laser treatment, you simply shine the light on the targeted area for a short time, (depending on the strength and output of your laser). Then you move onto the next area. It is fast and easy. The time of treatment with the super pulsed laser ranges from seconds to minutes 
The therapy improves micro-blood and lymph circulation, activates anti-oedematous processes, promotes cellular regeneration and inhibits inflammation.
What is patient’s perspective? Living with lymphoedema is not easy. Meaghan Barnard posted her story on YouTube. Meaghan admitted “roughly 90% of my day I’m in pain. It hurts when I walk. It hurts to move, and it affects my mobility. Imagine having your arm or leg in a vice. It’s constant pressure all the time”.
Hands on Practical application Sharon Tilley, Senior Physiotherapist and Owner at the Lymphoedema and Laser Therapy Clinic, Adelaide, South Australia is a current director of the Australasian Lymphology Association. Sharon is also a member of The Australian Medical laser Association (AMLA). She recommends using the 810nm and 830nm lasers for treating pain and using a 904nm laser (due to superior penetration depth of 3-5cm) to help the reduction of fibrosis in chronic lymphoedema.
Conclusion Lymphoedema is a painful and debilitating condition that progressively gets worse over time. It has a serious adverse impact on the quality of life for patients. There is no cure for lymphoedema, but it can be reduced or managed with appropriate intervention. MLS laser is an additional tool to help patients cope with the painful symptoms and make life bearable. 
Learning Outcomes Understand how laser therapy works in general. Review outcomes of several studies using laser therapy to treat lymphoedema. Understand how MLS laser therapy works i.e. scanning laser.

Session 2C: Medi - flat knit made to measure tips and tricks    

Alex Carver, Mandy Galbraith, Mitch Hart and Karolina Velayuthen, Medi Team

Sponsored by Medi Australia

In this session we will get into the nitty gritty of flat knit made to measure tips for pantyhose, toe caps, gloves, and armsleeves. How to measure for medi garments to ensure a good fit with recommendations based on how the garment is produced and sewn together. We will also cover some suggestions for dealing with: garments staying in place, donning, skin irritation, activity, and other issues clinicians have. Medi is continuously researching and developing new ideas for improving made to measure garment choices. This session will include the latest options for medi garments and how to measure and order them. There will be hands on measuring as well as demonstrations in this practical session with examples of complex and interesting garment choices.

Session 2D: Obesity and lymphoedema solutions and support for patients and therapists 

Christine Hemmann-Moll, Juzo GmbH

Sponsored by OAPL

With over 30 years garment measurement experience within the German Lymphological arena Christine Hemmann-Moll, on behalf of Juzo, will return to the ALA Conference for her third visit. During her extensive career Christine has measured and supplied garments for ALL major suppliers and thus has a wealth of knowledge across all aspects of garment measurement and fitting, including her extensive knowledge across all manufacturers for Custom Compression Garments for the ongoing care within Obesity and associated Lymphoedema. With her knowledge across these many manufacturers Christine understands the nuances between the various suppliers and will demonstrate the specifics for when fitting Juzo Compression Garments. With her wealth knowledge across all aspects of garment fitting for Lymphoedema Christine has a huge array of tips, tricks and more importantly measuring, fitting, and donning/doffing techniques that can be used in these delicate and often challenging areas. Importantly looking at the choice of garment from the perspective of the patient, whilst maintaining the clinical requirement. The main aspects covered will include: Compression garments, prescribing and measurement for Lymphoedema a complication of Obesity – with an emphasis on special garment choices for such a condition, from both the clinical and patient perspective.

Session 2E: Challenging experience – expanding horizons 

Robyn Box MPhty PhD APAM, APA Cancer Care & Lymphoedema Physiotherapist and Hildegard Reul-Hirche, Physiotherapy Department Royal Brisbane & Women's Hospital 

Many experienced lymphoedema therapists act as mentors to newly qualified and developing therapists. This workshop aims to provide these Lymphoedema therapists with an opportunity to:
•    Share knowledge 
•    Brainstorm with peers
•    Extend horizons without service provision restrictions
•    Consider all options
Four complex cases will be workshopped in a round table discussion format with interactive participation.

Session 3A: Using the Lymphscanner in clinical practice: a case study-led workshop 

Gillian Buckley, Physiotherapist, Clinical Advisor, Haddenham Healthcare and Melody Brown, Occupational Therapist, Clinical Advisor, Haddenham Healthcare

Sponsored by Haddenham Healthcare 

The Haddenham Healthcare clinical team has continued to gain experience in the use of the Lymphscanner, we want to expand on what we have already shared with you via our online training modules and individual discussions. This session will allow you to explore ways in which incorporating the Lymphscanner into your clinical practice can assist you in developing your treatment and record keeping. Through case studies, demonstration and discussion with clinicians who use the device we will explore innovative use of the Lymphscnnner. We will cover topics such as early intervention, scan and spot assessment as well as guiding massage pathways. We hope to discuss the implication of fatty change to the readings and how we might measure fibrosis. Importantly, we will discuss ideas around record keeping, ways by which the information can be translated into practical discussion with clients as well as be used in conjunction with other assessment modalities. We suggest that prior to attending this workshop you view the learning modules on our Haddenham online training site https://haddenham-australia.thinkific.com/ however this is not essential as we will review fundamental principles. This workshop is relevant to those that already have a lymphscanner as well as for those interested.

Session 3B: Complex cases in chronic oedema - a practical guide to assessment and diagnosis (Pre-recorded and repeat session)

Professor Vaughan Keeley, Consultant Physiciain in Lymphoedema, Royal Derby Hospital, Derby, UK

Interactive complex cases discussions with cases provided by presenter. Main learning outcome is: to increase the confidence of participants in identifying and managing complex cases.

Session 3C: Academic writing masterclass 

Dr Elizabeth Dylke, Senior Lecturer in the Discipline of Physiotherapy at the University of Sydney 

In this practical workshop, we will work through writing strategies focusing on how: to get started, to develop a clear narrative, to keep writing when you get stuck and to write a lot.  We will also use examples from the literature on how to make little changes to make writing clearer.  Finally we will have time to work on challenges that you are facing in your own writing journeys.

Session 3D: Lymph cupping: another tool for your treatment room? 

Dr Brenda Svensson, Lourdes Hospital and Community Health Service, and Revitalise Occupational Therapy 

Lymph cupping is a form of gliding negative pressure therapy that combines techniques used in manual lymph drainage, scar management and myofascial cupping. Unlike traditional static forms of cupping, lymph cupping uses combinations of circular and gliding strokes. It can be used to soften fibrotic tissue, increase movement in tight or adhered areas (e.g. post-radiotherapy) and assist lymph drainage. Rather than treatment recipes, this workshop will provide general guidelines, precautions, and case studies to highlight how lymph cupping can be used in the lymphoedema clinic. Participants will have the opportunity to practice lymph cupping techniques and participate in a skill-sharing forum about lymph cupping in the clinic and home programs. Participants who currently use cupping in their clinical practice are invited to bring their cups, knowledge, and experience to share with the group. During the workshop, silicone cups (and coconut oil) will be used to practice techniques while participants are in a seated position. Participants are asked to bring a towel and wear clothing that allows access to their thigh (shorts, loose skirt) and upper back (bra straps can just be moved off the shoulders) for practice of lymph cupping techniques. For this session please bring a towel and wear clothing that allows access to your shoulders and legs.

Session 3E: Lymph taping for beginners (Repeat session) 

Dr Jan Douglass, Accredited MTC Lymph Taping Instructor, Moving Lymph Pty Ltd

Advances in lymph taping practice and research are presenting new understandings into the principles of application and the mechanism of effect in the use of kinesiology tape to promote lymphatic function. This workshop overviews the history, theory and physiological effects of lymph taping, and discusses the emerging evidence for the effectiveness of lymph tape to replace compression therapies. In this hands-on workshop participants will learn to apply lymph tapes to address hand oedema using the most up to date techniques as taught by the Medical Taping Concept group in the Netherlands. Clinical reasoning and application of tape to other issues will be discussed. Enough tape to complete the classroom activities will be supplied.

Saturday 15 May 2021

Breakfast Session 1: Introducing a new generation of flat knit technology 

Kate Rogers 

Sponsored by Essity

Imagine a world with precise anatomical shaping. Jobst is driven by innovation and welcomes the addition of the Jobst Confidence line. A fabric which utilises 3D knitting technology, Jobst Confidence is provides adaptive technology to provide a precise fit for every patient. We welcome Kate Rogers to provide her experience with the new technology in the format of various patient case studies.

Breakfast Session 2: SIGVARIS PLUS PROGRAM  

Susan Butcher, Clincial Manager, SIGVARIS GROUP

Sponsored by SIGVARIS GROUP

We all want the best outcomes for our patients. Join us at our breakfast session to learn how the SIGVARIS Plus Membership Program can benefit both you and your patients. Contrarily to the SWEP program in Victoria and ENABLE in NSW with its limited choice of garment, time delays and overstretched funding issues the SIGVARIS Plus Membership Program focuses on the compliance issue with guaranteed immediate access to any needed garment with affordable payment options. During our breakfast session we will cover: Patient compliance and how can we increase it. Availability of products Affordability of the program/payment options Membership and the program How to become a Subscriber Therapist incentive SIGVARIS support & warranty Patient feedback.

Sunday 16 May 2021

Breakfast Session 3: Using compression pumps to make better use of your time AND improve clinical efficacy: Demonstrated with case studies 

Jen Sanderson, Medi-Rent 

Sponsored by Medi-Rent

Sequential Intermittent Pneumatic Compression (SIPC) is an established treatment modality for lymphatic, venous, and arterial pathologies. The case study format of this session will demonstrate effective treatment protocols in a mixture of acute, chronic, and wounds presentations. The content will discuss safe prescription of SIPC, progression of settings, and transition to a maintenance phase of treatment. Learn from the insights of a time-poor physiotherapy lymphoedema therapist on models of care using SIPC to improve therapy efficiency and patient outcomes. This presentation will take the form of multiple case studies relevant to therapists working in public health and private practice. Key learning objectives: Learn about strategies using SIPC to save clinical time, reduce patient costs, and alleviate the demand on public health systems: Understand the clinical rationale of SIPC in the treatment of a range of presentations at various stages of disease: Learn about various SIPC treatment protocols throughout the different phases of treatment and management: Learn how to prescribe and progress SIPC settings safely: Experience SIPC- use the opportunity to try the compression pumps on within the session to understand the various settings. If you miss out, please visit the Medi-Rent booth.

Breakfast Session 4: Medivision - mobile contactless measuring device   

Alex Carver, Mandy Galbraith, Mitch Hart and Karolina Velayuthe, Medi team 

Sponsored by Medi Australia

Demonstration of and presentation on medivision; The first mobile contactless measuring device. This device and software will assist the clinician in measuring quickly, accurately, and safely. Learning to use the device is easy and intuitive. Measuring, garment choice and ordering in a step by step process with automatic documentation for future reference. The device does not replace the clinical skills of the therapist, it enhances them and helps save time and errors in ready to wear garment choice and made to measure garment fitting. The session will include a hands-on measuring opportunity with the device as well as comments on its usage by current users of the device.

Session 8A: Genital and multi causal oedema - the use of treatment options, compression therapy and patient support    

Christine Hemmann-Moll, Juzo GmbH

Sponsored by OAPL

With over 30 years garment measurement experience within the German Lymphological arena Christine Hemmann-Moll, on behalf of Juzo, will return to the ALA Conference for her third visit. During her extensive career Christine has measured and supplied garments for ALL major suppliers and thus has a wealth of knowledge across all aspects of garment measurement and fitting, including extensive knowledge for the use of Compression Garments for the ongoing care with Genital & Multi Causal Oedema. With her knowledge across many manufacturers Christine understands the nuances between the various suppliers and will demonstrate the specifics for when fitting Juzo Compression Garments.With her wealth knowledge across all aspects of garment fitting for Lymphoedema and Lipoedema Christine has a huge array of tips, tricks and more importantly measuring and fitting techniques that can be used in these delicate and often challenging areas. The main aspects covered will include: Compression garments, prescribing and measurement for Genital & Multi Causal Oedema – with an emphasis on special garment choices for such conditions.

Session 8B: Lymph taping for beginners (Repeat session)

Dr Jan Douglass, Accredited MTC Lymph Taping Instructor, Moving Lymph Pty Ltd

Advances in lymph taping practice and research are presenting new understandings into the principles of application and the mechanism of effect in the use of kinesiology tape to promote lymphatic function. This workshop overviews the history, theory and physiological effects of lymph taping, and discusses the emerging evidence for the effectiveness of lymph tape to replace compression therapies. In this hands-on workshop participants will learn to apply lymph tapes to address hand oedema using the most up to date techniques as taught by the Medical Taping Concept group in the Netherlands. Clinical reasoning and application of tape to other issues will be discussed. Enough tape to complete the classroom activities will be supplied.

Session 8C: Medi - Circaid inelastic compression - measuring and fitting     

Alex Carver, Mandy Galbraith, Mitch Hart and Karolina Velayuthe, Medi team

Sponsored by Medi Australia

Circaid provides measurable and instantly adjustable inelastic compression for venous and lymphatic disorders during day and night use. circaid garments promote self-management and thus an increased patient compliance as well as an improved quality of life. In this session we will cover measuring and fitting of Circaid garments for upper and lower limb as well as which Circaid product to use for Decongestion, Transition and Maintenance. Medi has made some improvements to some of the Circaid products and these will be demonstrated. There will be hands on measuring and fitting as well as examples of complex garments for specific patients and the outcomes.

Session 8D: The ups and downs of Lymphoedema and wound care (part 1)     

Bekk Christensen and Dr John Bingley

A practical look at care for patients who may have wounds or leaking legs and lymphoedema. This session will include fundamentals of wound healing, mechanisms for oedema (especially lower limb) and how oedema influences wound healing, how to assess the different types of wound you may encounter and practical care to encourage wound healing. It is suggested you attend both part 1 and part 2 for maximum benefit.

Session 9A:  Lymbase, a free software solution for record keeping and a digitised pathway for garment selection 

Dr Robyn Sierla, Lymbase, Helen Chamberlain, Haddenham Healthcare and Mythili Baker, Lymbase

Sponsored by Haddenham Healthcare, Lymbase 

Lymbase is a secure, clinician-led development to improve data management for lymphoedema therapists. Lymbase is designed to create efficiencies for your clinical practice and enhance communication of the changes observed during treatment. At the same time Lymbase creates a de-identified learning health environment for research. Lymbase safely stores, processes, and displays assessment data; and enables the export of session summaries, graphs, and progress notes, to share with patients, referrers, and electronic medical record. A process of consensus was used to identify the data set and clinicians have provided feedback at all stages of the development. First and foremost, this is a tool for the practitioner. In a unique collaboration with Haddenham Healthcare Lymbase will also provide you with a pathway and support for garment measuring, sizing, and choice. Lymbase digitises the search for a compression garment and simplifies the ordering system. In this session we will not only cover the research underpinning Lymbase and the development process but will allow you to experience the software platform first-hand, exploring its functions and capabilities. This workshop will explore a new pathway for record keeping and garment selection in an interactive environment. Come and see if Lymbase might be a solution for you.

Session 9B: Complex cases in chronic oedema - a practical guide to assessment and diagnosis (Pre-recorded and repeat session)

Professor Vaughan Keeley, Consultant Physiciain in Lymphoedema, Royal Derby Hospital, Derby, UK

Interactive complex cases discussions with cases provided by presenter. Main learning outcome is: to increase the confidence of participants in identifying and managing complex cases.

Session 9C: Building your paediatric lymphoedema toolbox   

Jessica Shapland, Occupational Therapist, Children’s Health Queensland Hospital and Health Service and Tamsin Mahoney, Occupational Therapist - Advanced Burns/ Vascular, Children’s Health Queensland Hospital and Health Service

A theoretical and practical session highlighting the challenges, rewards and clinical nuances of working with infants, children and teenagers who have lymphatic conditions.

Session 9D: The ups and downs of Lymphoedema and wound care (part 2)     

Bekk Christensen and Dr John Bingley

A practical look at care for patients who may have wounds or leaking legs and lymphoedema. This session will include fundamentals of wound healing, mechanisms for oedema (especially lower limb) and how oedema influences wound healing, how to assess the different types of wound you may encounter and practical care to encourage wound healing. It is suggested you attend both part 1 and part 2 for maximum benefit.