This course is provided online and is for Certified Lymphedema Therapists (CLT's) ONLY with a valid professional license. Verification of valid license and certification is required before access will be given to the online portal. To register, click on the link below or call (800) 863-5935.
CLT's must send proof of graduation from a lymphedema certification program with a minimum of 135 hours and a copy of a valid professional license. Send license and certificate of completion via fax to (772) 589-0306 or email through our contact form. Once license and CLT status are verified, your registration will be processed and logon credentials/instructions will be sent via email so you may begin your online course.
The Academy of Lymphatic Studies’ primary objective is to promote high professional standards and the continuing professional competence of health care practitioners by promoting the quality and integrity of continuing education to practitioners in the field of lymphedema management.
As a member of the North American Lymphedema Education Association (NALEA) the Academy of Lymphatic Studies shares the common goals of other NALEA member schools in setting and maintaining the highest standards of lymphedema education in North America.
The Academy’s decision to implement a recertification program is based upon an important 2012 NALEA survey conducted by the American Lymphedema Framework Project (ALFP). In this survey the vast majority of LANA recognized Certified Lymphedema Therapists (CLT’s) supported this advancement.
As the ranks of specialists grow and the field further defines itself by proving superior clinical outcomes in the evidence based literature, it is ever more important that competency is demonstrated to support continuation of Complete Decongestive Therapy as the gold standard method in the treatment and management of lymphedema.
The recertification cycle is five (5) years from the date of CLT graduation.
To ensure the continued quality and to uphold and strengthen the lymphedema practitioners’ skills and knowledge base, it is recommended that CLT’s who graduated on or before 12/31/2010 to participate in a recertification course before 12/31/2015.
For CLT’s who graduated on or after 1/1/2011 it is recommended to participate in the recertification course within five (5) years from the original graduation date.
The recertification course is provided in an online format and consists of ten (10) modules providing a combination of theoretical information relevant to the CLT profession and hands-on techniques. Hands-on techniques are provided in video format and offer a review of the basic techniques of Manual Lymph Drainage (MLD), to include combination techniques, as well as a review of treatment sequences for lymphedema affecting the upper and lower extremities, bandaging and garment measuring techniques. All module topics are narrated. A cumulative exam based on the module lecture topics is provided at the end of the course.
Module 1 – Anatomy of the Lymphatic System
- Different components of the lymphatic system.
Lymph capillaries, precollectors, collectors, trunks and ducts, lymph nodes. Superficial and deep lymphatic system.
- The integumentary system, interstitium and connective tissue.
Structure, functions, clinical relevance.
- Individual functions of lymphatic vessels and lymph nodes.
Lymph formation, lymphatic fluid, transport, volume, lymph node filtration, immune function.
- Components composing the lymphatic fluid and their individual functions.
Water, protein, cells/cell fragments and fat.
- Location of major groups of lymph nodes in the body.
- Lymphatic drainage of the extremities, trunk, head and genital areas.
- Lymphatic watersheds, lymphatic territories, lymphatic quadrants and lymphatic bundles, lymphatic anastomoses.
- Differentiation between the anastomoses of the lymphatic system used in treatment.
- Lymphedema versus edema, causes of edema and lymphedema.
Module 2 – Microcirculation and Physiology
- Mechanisms of fluid transfer between the blood capillaries, tissues and lymph capillaries.
Diffusion, filtration, reabsorption, osmosis, osmotic and colloid-osmotic pressures, blood capillary pressure, tissue pressure, microcirculation.
- Starlings Law – relevant pressure values and clinical relevance.
- Venous return, active and passive hyperemia, hypoproteinemia.
- Function of the lymphatic system and its role in fluid homeostasis.
Lymph time volume, functional reserve.
- Different forms of insufficiencies of the lymphatic system.
Dynamic insufficiency, mechanical insufficiency, combined forms.
Module 3 – Lymphedema and Contraindications for CDT
- Causes of lymphedema, etiology, classification, staging and severity.
- Differentiation between primary and secondary lymphedema, and the various stages of lymphedema.
Filariasis, traumatic edema, self-induced lymphedema, malignant and benign causes, reflux and combinations.
- Diagnostic procedures and imaging techniques used for the lymphatic system, differential diagnosis.
- Complications associated with lymphedema and necessary treatment modifications.
- Indications and contraindications associated with Complete Decongestive Therapy.
Absolute and relative contraindications in general and restrictions/adaptations of CDT on various body parts.
Module 4 – Complications of Lymphedema
- Various complications that may be associated with lymphedema and how they may affect the treatment itself and/or treatment outcomes.
Scars, hyperkeratosis, papillomas, warts, general infections, cellulitis, fungal infections, lymphatic cysts and fistulas, teleangiectasia, skin folds, lobular growths, axillary web syndrome (AWS), malignancies, radiation fibrosis, collateral veins, paralysis, ulcerations, debulking procedures.
- The body’s reaction to an accumulation of protein-rich lymph fluid (lymph stasis).
Collateral circulation, lymphatic safety factor (LSF), lympho-lymphatic and lympho-venous, anastomoses, lymph vasa-vasorum, macrophages.
- Effectiveness of modalities used for the treatment of lymphedema in addition to CDT.
Pneumatic compression pumps (chambered and sequential), traditional massage techniques, electro therapy, ultrasound, thermo therapy, elastic taping, deep oscillation, low-level-laser therapy (LLLT), medication (diuretics, benzopyrones, antibiotics and antimycotics), dietary measures, surgical interventions.
Module 5 – Venous and Arterial Insufficiencies, Lipedema, Lipo-Lymphedema, Phlebo-Lipo-Lymphedema
- Pathophysiology of chronic venous insufficiencies (CVI) and the stages of this condition (stage 0 through stage III).
Venous dynamics, post-thrombotic syndrome (PTS), signs and symptoms of deep venous thrombosis (DVT).
- Effects of venous insufficiencies as they relate to the dynamics on the blood capillary level (filtration and reabsorption).
- Chronic venous insufficiency (CVI) and the effects of CVI on the lymphatic system.
Dynamic insufficiency, mechanical insufficiency, combined forms, phlebo-lympho dynamic and phlebo-lympho-static insufficiencies.
- Pathophysiology of lipedema and the effects of lipedema on the lymphatic system.
Signs, symptoms and differentiation between pure lipedema, lipo-lymphedema, phlebo-lipo-lymphedema and treatment approaches.
Module 6 – Post-Traumatic, Post-Surgical Edema Head and Neck Lymphedema (HNL) and Lymphedema of other Geneses
- Inflammatory response of soft tissues to traumatic events and consequences for the lymphatic system.
Trauma, blunt trauma, surgical events, wounds (venous and arterial). Signs and symptoms of inflammation in the soft tissues .
- Negative effects of swelling associated with trauma on the soft tissues, specifically on the lymphatic system.
- Effects of chronic inflammatory processes associated with rheumatoid arthritis and reflex sympathetic dystrophy on the lymphatic system.
Areas and structures of the body without the presence of lymphatic vessels.
- The role of CDT in acute traumatic edema and chronic inflammatory processes.
- Pathophysiology of primary and secondary lymphostatic encephalopathy.
Drainage pathways of lymphatic loads (lymph fluid) from the central nervous system.
- Head and neck lymphedema (HNL).
Pathophysiology, treatment, the role of CDT in the treatment of HNL, treatment modifications.
- Cyclic-idiopathic edema.
The role of CDT in the treatment of cyclic-idiopathic edema.
- Evaluation techniques for lymphedema.
Subjective, past and present medical history, social history, medications, objective assessment, observation, palpation, Stemmer sign, BMI, posture alignment, differential diagnosis, plan of care, short and long term goals.
- Documentation modalities for lymphedema.
Photographic, perometer, circumferential and volumetric measurements, water displacement, bio-electrical impedance.
Module 7 – Components of Complete Decongestive Therapy
- Goals of treatment phase I and phase II of Complete Decongestive Therapy (CDT) and factors that determine the end of phase I of CDT, and the beginning of phase II.
- Components of (CDT) and their effects (including video demonstrations).
Complete review of manual lymph drainage and special techniques – techniques and effects.
Skin care – methods and materials for lymphedematous skin, fungal infections, and wounds. Compression therapy – principles for phase I and II of CDT, materials, compression garments.
Decongestive exercises – principles, exercise modalities for the upper and lower extremities.
- The principle of the Law of LaPlace and the role of padding in lymphedema management.
- Working and resting pressures associated with long-stretch and short-stretch bandages.
- Compression classes in lymphedema garments
Compression garment styles and appropriate choices of compression classes for various types of lymphedema.
- Discussion of additional compression alternatives in addition to short-stretch bandages and compression garments.
- Beneficial activities and do’s and don’ts for lymphedema.
- Video segments including the complete review of all MLD techniques to include special techniques, and practical demonstration of the application of padded short-stretch bandages on the upper and lower extremities.
Module 8 – Billing
- Billing codes for lymphedema management
Module 9 – CDT Treatment Sequences
- Video review of treatment sequences for lymphedema affecting the trunk and upper and lower extremities (unilateral and bilateral).
- Unilateral upper extremity lymphedema with involvement of the trunk,
- Unilateral upper extremity lymphedema without involvement of the trunk;
- Bilateral upper extremity lymphedema with involvement of the trunk;
- Bilateral upper extremity lymphedema without involvement of the trunk;
- Unilateral lower extremity lymphedema with involvement of the trunk;
- Unilateral lower extremity lymphedema without involvement of the trunk;
- Bilateral lower extremity lymphedema with involvement of the trunk;
- Bilateral lower extremity lymphedema without involvement of the trunk.
- Video review of treatment sequences for the face, neck, anterior and posterior head and neck.
Module 10 – Compression Garment Measuring
- Video review of ready-made and custom compression garments, to include knee-high, thigh-high and pantyhose (open-toe and full foot), arm sleeves, gloves and gauntlets.
This review is provided using JUZO measuring charts; however, it can be applied to measure for all garments from different manufacturers since measuring points and techniques are very similar among all garment manufacturers.
The course tuition is $695.00. ACOLS alumni are eligible for our 10% alumni discount.
To attend our CLT Refresher / Recertification online course, participants must provide proof of the following:
- Successful completion of a minimum 135-hour CLT Certification program.
- Current, unrestricted license as an RN, OT, COTA, PT, PTA, MD, DO, ATC, DC, MD, DO, PA or Massage Therapists who have completed 500 massage school hours* and/or National Therapeutic Massage and Bodywork Certification.
This course is provided online and is for Certified Lymphedema Therapists (CLT's) ONLY. Verification of certification is required before access will be given to the online portal. To register, click on the link above or call (800) 863-5935.
CLT's must send proof of graduation from a lymphedema certification program with a minimum of 135 hours and copy of professional license. Send license and certificate of completion via fax to (772) 589-0306 or email through our contact form. Once license and CLT status are verified, your registration will be processed and logon credentials/instructions will be sent via email so you may begin your online course.
Continuing Education Credits (CEU's)
CEU's are available. Each state and profession are different, so please contact our Admissions Department for more detailed information regarding CEU approvals for this course.
Academy of Lymphatic Studies is an approved provider for the AOTA and NCBTMB. In addition, this online course has been approved by the Florida Board of Physical Therapy. This CLT Refresher/Recertification course meets the educational requirements for the re-certification process for the Lymphology Association of North America (LANA®) National Certification (CLT-LANA) (for more information visit www.clt-lana.org).