Chanwimalueang, N., Ekataksin, W., Piyaman, P., Pattanapen, G., & Hanboon, B.K. (2015). Twisting Tourniquet^® technique: Introducing Schnogh, a novel device and its effectiveness in treating primary and secondary lymphedema of extremities. Cancer Medicine, 4, 1514–1524.

To describe the clinical effectiveness of a particular device in decongestive therapy

The Schnogh device consists of fabric and other parts that enable a spiral twisting that delivers sequential compression for 15 minutes followed by decompression for five minutes over the course of an hour. Patients analyzed in this study completed five days of treatment over one week.

• N = 647
• MEAN AGE = 56 years (range = 6–82 years)
• MALES: 12%, FEMALES: 88%
• KEY DISEASE CHARACTERISTICS: Varied causes of primary and secondary limb lymphedema for upper or lower limbs were included. Among participants, 95% of those with arm lymphedema had breast cancer, and 53.8% of those with lower limb lymphedema had cervical, uterine, or ovarian cancer.

• SITE: Single site  
• SETTING TYPE: Outpatient    
• LOCATION: Thailand

• APPLICATIONS: Pediatrics

Prospective, descriptive study

• Limb circumference for calculated limb volume

The average percent limb volume reduction was 50.2% for upper extremities and 55.6% for lower extremities.

Decompression therapy as provided with the device described here was effective in reducing lymphedema volume.

• Risk of bias (no control group)
• Risk of bias (no random assignment)

Complete decongestive therapy is effective for lymphedema reduction with most evidence describing its use in upper extremities. The findings in this study suggested that this device can provide similar results with no manual decongestive component. Additional well-designed studies are needed to confirm that this approach yields comparable or better results than current treatments.