your group came up with more difficult to reach consensus on among the working group members? How was the group able to overcome those challenges? MM - The working group process was very
collegial, and, for me, it was a very positive experience coming out of the Summit. There was strong agreement on the essential components of maintenance-phase care from the outset, so we did not have any difficulty reaching consensus. Most of our discussion focused not on what should be included, but on how best to describe the recommendations in a way that stayed true to our three guiding principles— that best care is interdisciplinary, tailored to individual needs, and focused on empowering the individual to self-manage their lymphedema. The process itself was very collaborative.
• Day-time compression garments: 3 sets per affected body part every 6 months • Night-time compression garments: 2 garments per affected body part every 2 years • Compression bandaging systems and supplies • Gradient compression wraps with adjustable straps • Necessary accessories for gradient compression garments and wraps, including: aids for donning and doffing items, fillers, lining, padding, zippers
The working group included people from different care settings and with different scopes of practice, so everyone brought a unique perspective to the discussion. The different viewpoints really strengthened the recommendations and helped ensure they were relevant to clinical practice. As a group, we would draft sections, come together to review them, discuss and debate the wording, and then revise the recommendations based on those discussions. It was exciting to see the recommendations evolve, become clearer and more fine-tuned over time. We were mindful that wording matters. We wanted the recommendations to also align with the U.S. Lymphedema Treatment Act, so that they reflect current policy and help support access to appropriate coverage for people living with lymphedema. Considering an insurance and coverage lens, we had to be careful though not to be overly prescriptive
AK - Were any of the six recommendations
• Skin and nail care • Compression garment application and care • Self-lymphatic massage • Decongestive exercise • As needed: selfapplication multicomponent compression bandaging/ night-time garment
This is the fifth in a series of transcribed interviews highlighting the published body of work resulting from the LANA/ACS Summit. By highlighting these research papers and consensus statements, we hope to promote the concepts and facilitate moving them into daily practice. Readers are encouraged to access the reference links at the end of the article to read the research papers and some supporting evidence in their entirety.
• Options for self-management to inform shared decision-making • Signs and symptoms of cellulitis • Identification of, and mitigation strategies to address barriers to self-management • Counseling to support healthy lifestyle behaviors
An interview with Margie McNeely
• Assessment of limb volume and body weight • Evaluation of garment wear and fit • Review of selfmanagement plan • Further reduction treatment as needed • Management of cellulitis and other lymphedema complications
Essential components of the maintenance phase of decongestive therapy
Consensus Statement
in how the recommendations were written. For example, we avoided setting exact time frames and treatment schedules as we know that lymphedema management needs can be different from person to person and may change over time. Some individuals need more support at certain points, while others need less. One thing I learned through this process is that recommendations can be interpreted very narrowly, with insurance funding aligned to the exact prescription rather than to individual needs. Keeping the wording flexible was important to ensure the recommendations reflect real-world care and can be applied across different healthcare systems and coverage models. AK - What is the evidence for your group’s recommendation to include nighttime compression as well as daytime compression for effectiveness?
Margaret (Margie) McNeely is a Professor in the Departments of Physical Therapy and Oncology at the University of Alberta, in a jointly funded position with Cancer Care Alberta. She is the Director of the Cancer Rehabilitation Research Clinic at the University of Alberta. Anna Kennedy is a founding member of the Canadian Lymphedema Framework and Editor-in-Chief of the Pathways magazine. In 2012 she was awarded the Queen Elizabeth Diamond Jubilee Medal.
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Spring 2026