When it comes to clinical practice, what matters most to real-world MLD therapists simply isn’t what’s being measured in “Level I evidence”. To understand this disconnect we need to revisit what evidence based practice really means. Evidence based therapy is a synthesis of research evidence, clinical experience and observation, in the context of the desired outcomes of the recipient. Relying on Level 1 evidence alone is just not enough. Yet systematic reviews and meta-analy

An easy - and free - way for therapists to assess clinical progress is to use an analogue scale. Image by Volodymyr Hryshchenko on Unsplash This can be a numeric scale such as the one developed in 1932 by Rensis Likert ( 1 ) to measure attitudes. Typically a 5- or 7-point ordinal scale, respondents rate the degree to which they agree or disagree with a statement. It is essentially a rating scale, usually presented as a score between 1 - 5 or 1 - 10, where the person selects

Randomised controlled trials are not suited to assessing the effectiveness of treatments for lymphoedema and other choric diseases.