Assessment
Early identification and intervention is recommended to prevent deteriorating function and development of more severe problems such as shoulder hand syndrome.
- Visual inspection – obvious swelling of the affected hand/wrist/forearm in comparison with the other arm
- Circumferential measurement – using a tape measure
- Volumetric assessment using a volumeter (recommended mainly for research purpose)
Treatment/management
There is limited scientific evidence for the management of post stroke hand oedema and interventions should be selected based on the individual needs of the patient. Suggested interventions include:
- Removing jewellery such as rings and watches which may become too tight and restrict blood flow
- Positioning – arm elevated and in an extended position
- Support – lap tray/pillow/table placed to side of patient with pillow for support
- Education of patient, family, carers and other healthcare staff on the management of symptoms and effective positioning programme
- Active movement where possible and maintaining passive range of movement
- Light retrograde massage – may reduce swelling for increased range of movement and functional use
- Compression garments – may control and reduce swelling
- Intermittent pneumatic compression has been shown to be ineffective in reducing upper limb oedema
Page last reviewed: 23 Mar 2021
