H-e-a-t Inc Spa Kur Therapy Development Education & Training
California School #120586
would like to take this opportunity to introduce our company's various seminars, workshops, lectures; our training supporting workbooks, publications and videos, and educational library.

We are constantly researching and developing new materials in order to assist you in your business and therapeutic endeavors.

• On-Site Training

• 
  from Dr Reinhard Bergel PhD

Spa Kur Therapy TRAINING DESCRIPTION

It is my goal to provide an intensive education and training in the theory and practical application of Spa Kur Therapy.

The training content follows standards in Spa Kur Therapy based on clinical research and applications set by the International Society of Medical Hydrology ISMH Rheumatology Mineral Water Drinking Climatology Balneo Dermatology, the German Society of Balneology and Kur Therapy, American Physical Therapy Association and many more other organizations promoting wellness program procedures based on ongoing clinical research.
Upon completion of this training we are confident that you will return to successful clinical practice in Spa Kur Therapy.

THEORY AND PRACTICE

How to "BUILD A SPA” facility financial and architectural planning square footage, set up-payroll- expense calculations, return on expenses, net profit analysis break-even analysis cash flow projections.

How to "OPERATE A Spa Kur Therapy FACILITY", management human resources job descriptions policies and procedures including continuous education training med spa clinic programs and physical therapy program.

How to "Do Spa Kur Therapy TREATMENTS." It is the objective to provide basic theoretical and practical instruction in various Spa Kur therapies designed for allied health professionals Spa operators, physical therapist massage therapists estheticians.
Sincerely yours,Dr Reinhard R. Bergel

Director
H-e-a-t Inc
(Health-enhancement-accessories-training)
Spa Kur Therapy Development Inc

H-e-a-t Spa 30
Spa Kur Therapy TRAINING

TARGET GROUP This basic training offers didactic and practical instruction of spa therapies designed for Spa operators physical therapist allied health professionals massage therapist and esthetician

TRAINING TIMES the training consists of thirty (30) classroom contact hours of theory and practicum, lasting three (3) consecutive days plus thirty (30) home study hours before the start of the classroom training. A home study knowledge test will be administered on day 1 of the classroom training

TRAINING PREREQUISITS The didactic and practical instruction of the training is designed for allied health professionals massage therapist and esthetician requiring anatomy and physiology basics

HOME STUDY The Spa Kur Therapy textbook will be provided before the training. The training participant is expected to complete 30 hours home study before the first day of class. This will develop an extensive knowledge of a large variety of Spa Kur therapies, as it will facilitate a smooth entry and progression of the classroom training

TRAINING DESCRIPTION The 30 hours classroom training involves hands-on work with simple applications of hydrotherapy and pelotherapy. The theory covers anatomy and physiology of the vascular and nervous system, indications and contraindications.

TRAINING OBJECTIVES it is the objective to provide basic theoretical and practical instruction in various Spa-Kur Therapies designed for allied health professional spa operators physical therapists massage therapists and estheticians

At the conclusion of the sixty (60) hours training, participant will have learned the basics of Spa Kur Therapy physiology and visceral anatomy recount indications and contraindications, perform and reproduce selective Spa Kur Therapy treatments.

TRAINING PARTICULARS due to hands-on training time enrollment is limited wear comfortable clothes sports bra 2 piece swimsuit

TRAINING CONTENT
Classroom Didactics 6 hours Home study didactics 30 hours
The vascular and nervous system anatomy physiology
Classroom Practicum 24 hours all of the following topics will be included in the training

HYDROTHERAPY theory and practice baths showers affusions ablutions underwater massage steam sauna thalasso therapy equipment operations and business management

AROMATHERAPY: theory and practice herbal and seaweed baths wraps packs loofah dry brushing equipment operations and business management

PELOTHERAPY theory and practice mud baths wraps packs parafango (paraffin mud) treatment equipment operations and business management

WELLNESS (KNEIPP) and SPA THERAPIES hydrotherapy herbal therapy exercise diet lifestyle and wellness practices equipment operations and business management

HOW TO "BUILD A SPA" financial and architectural planning square footage set up-payroll- expense calculations return on expenses net profit analysis break-even analysis cash flow projections

HOW TO "OPERATE A SPA " management human resources job descriptions policies and procedures including continuing education training med spa clinic programs and physical therapy program.

TRAINING SCHEDULE

H-e-a-t Spa LDC 50
Spa Kur Therapy & Lymph Drainage TRAINING

It is my goal to provide an intensive continuous education and training in the theoretical & practical application of Spa Kur Therapy & Lymph Drainage.

The training content follows standards in Spa Kur Therapy & Lymph Drainage based on clinical research and applications set by the
International Society of Medical Hydrology, Rheumatology, Climatology, Balneology, Dermatology, the German Society of Balneology and Kur Therapy,
International Society of Lymphology, American Physical Therapy Association and many more other organizations, promoting spa programs based on ongoing clinical research.

Upon completion of this continuous education training I am confident that you will return to continued successful clinical practice in Spa Kur Therapy & Lymph Drainage.

THEORY AND PRACTICE

How to "BUILD A Spa Kur Therapy” facility financial and architectural planning square footage, set up-payroll- expense calculations, return on expenses, net profit analysis break-even analysis cash flow projections.

How to "OPERATE A Spa Kur Therapy facility” employee management and job descriptions, policies & procedures including continuous education training, spa clinic and physical therapy programs.

How to "Do Spa Kur Therapy TREATMENTS." basic theoretical and practical instruction in various Spa Kur therapies designed for the allied health professional, Spa operator, physical therapist, massage therapist, skin and body care trained beauty care technician.

Sincerely yours,

Dr Reinhard R. Bergel
Director
H-e-a-t Inc
(Health-enhancement-accessories-training Inc)
Spa Kur Therapy Development

H-e-a-t Spa LDC 50
Spa Kur Therapy & Lymph Drainage Training

TARGET GROUP The Spa Kur Therapy & Lymph Drainage training offers basic didactic and practical instruction of spa therapies designed for the allied health professional, Spa operator, physical therapist, massage therapist, skin and body care trained beauty care technician.

TRAINING TIMES The Spa Kur Therapy & Lymph Drainage training consists of fifty (50) classroom contact hours of theory and practicum, lasting five (5) consecutive days plus sixty (60) home study hours before the start of the classroom training. A home study knowledge test will be administered on day 1 of the classroom training

TRAINING PREREQUISITS The Spa Kur Therapy & Lymph Drainage didactic and practical training is designed for the allied health professional, Spa operator, massage therapist, skin and body care trained beauty care technician requiring anatomy, physiology, neurology and lymphology basics

HOME STUDY The Spa Kur Therapy & Lymph Drainage text & DVD/video, respectively will be provided before the training. The Spa Kur Therapy & Lymph Drainage training participant is expected to complete 60 hours home study before the first day of class. This will develop an extensive knowledge of a large variety of Spa Kur therapies & Lymphology of anatomy, physiology, neurology and patho physiology of the vascular, nervous & lymphatic system, as it will facilitate a smooth entry and progression of the CLASSROOM training.

TRAINING DESCRIPTION The Spa Kur Therapy & Lymph Drainage 50 hours classroom training involves hands-on work with systematic applications of hydrotherapeutic modalities & procedures, manual & instrumental lymph drainage, garment applications as it applies in a slimming cellulite treatment and post surgery edema treatment. Topics include inner cleansing-tissue mineralizing & decongesting, exercise physiology and the physiological conditions for proper slimming, cellulite & edema reduction, recommendation of the application of pressotherapy, compression pumps, bandaging and fitting of compression garments benefiting slimming cellulite; edema reduction and venous insufficiencies following internationally accepted standards. The theory covers anatomy and physiology of the blood vascular, lymphatic and nervous system, treatment indications and contraindications.

TRAINING OBJECTIVES The Spa Kur Therapy & Lymph Drainage training objective is to provide basic theoretical and practical instruction in various Spa Kur Therapy & Lymph Drainage procedures designed for the allied health professional, Spa operator, physical therapist, massage therapist, skin and body care trained beauty care technician.
At the conclusion of the fifty (50) hours classroom training, participant will have learned the basics of Spa Kur Therapy & Lymph Drainage, physiology and visceral anatomy, recount indications and contraindications, perform and reproduce selective Spa Kur Therapy & Lymph Drainage treatments.

TRAINING PARTICULARS due to hands-on training time enrollment is limited wear comfortable clothes swimsuit sports bra 2 piece swimsuit

TRAINING CONTENT Classroom Didactics 15 hours Home study didactics 60 hours. The vascular and nervous system anatomy physiology
Classroom Practicum 35 hours all of the following topics will be included in the training

HYDROTHERAPY theory and practice baths showers affusions ablutions underwater massage steam sauna thalasso therapy equipment operations and business management

AROMATHERAPY: theory and practice herbal and seaweed baths wraps packs loofah dry brushing equipment operations and business management

PELOTHERAPY theory and practice mud baths wraps packs parafango (paraffin mud) treatment equipment operations and business management

WELLNESS (KNEIPP) & SPA THERAPIES hydrotherapy herbal therapy exercise diet lifestyle and wellness practices equipment operations and business management

MANUAL & INSTRUMENTAL LYMPH DRAINAGE THERAPY Cellulite & post surgery edema treatment theory and practice of systemic microcirculation, lymph drainage techniques, science of compression content follows the world wide accepted standards and consensus of the INTERNATIONAL SOCIETY OF LYMPHOLOGY((ISL Consensus Documents on the Diagnosis and Treatment of Peripheral Lymphedema
http://www.u.arizona.edu/~witte/ISL.htm),

HOW TO "BUILD A SPA" financial and architectural planning square footage set up-payroll- expense calculations return on expenses net profit analysis break-even analysis cash flow projections

HOW TO "OPERATE A SPA " management human resources job descriptions policies and procedures including continuing education training med spa clinic programs and physical therapy program.

TRAINING SCHEDULE

Manual & Instrumental Lymphdrainage (MLD & ILD) Compression Physiotherapy (CPT)

WORKSHOP & TRAINING DESCRIPTION

It is my goal to provide an intensive education and training in the theory and practical application of Compression Physiotherapy (CPT), including
Manual Lymph Drainage (MLD),
Instrumental Lymph Drainage (ILD),
Compression Bandaging,
Compression Garment Fitting,
Remedial Exercise and
Skin care.

The training content follows the world wide accepted standards and consensus of the INTERNATIONAL SOCIETY OF LYMPHOLOGY (ISL) in THE TREATMENT OF PERIPHERAL LYMPHEDEMA

(ISL Consensus Documents on the Diagnosis and Treatment of Peripheral Lymphedema
http://www.u.arizona.edu/~witte/ISL.htm),

as well as on clinical research and applications set by: Foeldi-MD, Asdonk-MD, Kubik-MD, Vodder, Hutschenreuther, MD, Mislin, MD, et al.

Upon completion of the training I am confident that you will return to successful clinical practice in Manual & Instrumental Lymph drainage as well as in Compression Physio Therapy (CPT), with measurable results.

Sincerely yours
Dr Reinhard R Bergel
Director
H-e-a-t (Health-enhancement-accessories-training Inc)
Spa Kur Therapy Development

H-e-a-t LDC10
INTRODUCTION & DEMONSTRATION WORKSHOP

MANUAL & INSTRUMENTAL LYMPH DRAINAGE (MLD & ILD) COMPRESSION THERAPY

TARGET GROUP This introduction & demonstration workshop offers practical information of manual and instrumental lymph drainage compression therapy techniques designed for Physiotherapist, massage therapist and skin care specialist.

DESCRIPTION Participant will learn fundamentals of skin and systemic physiology, anatomy and microcirculation of the vascular system, about techniques of manual and instrumental lymph drainage and compression therapies as it applies in a slimming cellulite edema treatment program. This introduction covers issues of detoxification-fasting-cleansing-exercise physiology and the physiological conditions for proper slimming cellulite and edema reduction. Recommendations of the application of compression pump, bandaging and fitting of compression garments benefiting slimming cellulite; edema reduction and venous insufficiencies follow internationally accepted standards.

OBJECTIVE At the conclusion of this introduction participant will have a basic understanding of: anatomy, physiology and fluid dynamics of the lymphatic system, compression pump and bandaging wrap procedures, principles and specific uses of compression garments. Manual & instrumental lymph drainage techniques (throat-abdomen-leg)

PARTICULARS Short time hands-on practice, enrollment is limited to 40.
Wear comfortable clothes (sports bra or 2 piece swim suit)

H-e-a-t LDC20
DEMONSTRATION & TRAINING WORKSHOP

MANUAL & INSTRUMENTAL LYMPH DRAINAGE (MLD & ILD) COMPRESSION THERAPY
CELLULITE AND POST SURGERY EDEMA TREATMENT

TARGET GROUP This demonstration & training offers practical instruction and of manual & instrumental lymph drainage designed for physiotherapist, massage therapist and skin care specialist.

TRAINING TIME is two (2) consecutive days, twenty (20) classroom hours of theory and practicum, plus thirty (30) home study hours before the start of the classroom training. A home study knowledge test will be administered on day 1 of the classroom training.

TRAINING PREREQUISITS The didactic and practical instruction of the training is designed for physiotherapist, massage therapist and skin care specialist requiring anatomy, physiology basics.

HOME STUDY The text and video will be provided before the training .The training participant is expected to complete 30 hours home study prior to the first day of class. This will develop an extensive knowledge of anatomy, physiology and pathophysiology of the lymphatic system, as it will facilitate a smooth entry and progression of the training.

TRAINING DESCRIPTION During the twenty (20) hours classroom training participants will learn fundamentals of skin and systemic physiology, anatomy and microcirculation of the vascular system, manual & instrumental lymph drainage techniques and compression bandaging, garment applications as it applies in a slimming cellulite treatment and post surgery edema treatment. The training covers issues of detoxification-fasting-cleansing-exercise physiology and the physiological conditions for proper slimming cellulite and edema reduction. Recommendation of the application of compression pumps, bandaging and fitting of compression garments benefiting slimming cellulite; edema reduction and venous insufficiencies follow internationally accepted standards.

TRAINING OBJECTIVES At the conclusion of the fifty (50) hours educational training participant will have learned the basics of: anatomy, physiology and fluid dynamics of the lymphatic system, compression pump and bandaging wrap procedures, principles and specific uses of compression garments, manual & instrumental lymph drainage techniques (throat-abdomen- flank-leg).

TRAINING PARTICULARS Due to hands-on training time, enrollment is limited to 20. Wear comfortable clothes (sports bra, 2 piece swim suit).

TRAINING CONTENT
Classroom Didactics 4 hours
Home study Didactics 30 hours
The lymphatic and venous systems: anatomy & histology; physiology & pathophysiology; fluid dynamics of lymphatic system
Classroom Practicum 16 Hours Client evaluation, Manual Lymph Drainage, hand stroke technique of throat, abdomen, flank, leg

TRAINING SCHEDULE

H-e-a-t LDT30 THERAPY 1
HEAD-FACE-CHEST
THE BASIC BEAUTY TREATMENT TRAINING

MANUAL & INSTRUMENTAL LYMPH DRAINAGE (MLD & ILD)
COMPRESSION THERAPY

TARGET GROUP This training offers didactic and practical instruction of manual & instrumental lymph drainage designed for the physiotherapist, massage therapist and skin care specialist.

TRAINING TIME is three (3) consecutive days, thirty (30) classroom contact hours of theory and practicum, plus thirty (30) home study hours before the start of the classroom training. A home study knowledge test will be administered on day 1 of the classroom training

TRAINING PREREQUISITS The didactic and practical instruction of the training is designed for the physiotherapist, massage therapist and skin care specialist requiring anatomy, physiology basics.

HOME STUDY The text and video will be provided before the training. Participant is expected to complete 30 hours home study before the first day of class. This will develop an extensive knowledge of anatomy, physiology and pathophysiology of the lymphatic system, as it will facilitate a smooth entry and progression of the training.

TRAINING DESCRIPTION The 30 hours classroom training involves hands-on work with application to head, face, neck, throat and chest as well as instruction on compression pump use The theory covers anatomy and physiology of the lymph vessel system, connective tissue, effects of lymph drainage, indications and contraindications. Edema & Lymphedema are described with emphasis on how lymph drainage can affect them.

TRAINING OBJECTIVES At the conclusion of the sixty (60) hours training, participant will have learned the basics of anatomy, physiology and fluid dynamics of the lymphatic system, recount indications & contraindications, perform & reproduce the treatment specifics of manual lymph drainage (ad modum Vodder & Asdonk, MD) and become prepared for a subsequent advanced five (5) day class room entire body training.

TRAINING PARTICULARS Due to hands-on training time, enrollment is limited to 20.
Wear comfortable clothes (sports bra, 2 piece swim suit)

TRAINING CONTENT
Classroom Didactics 6 hours
Home study Didactics 30 hours
The lymphatic and venous systems: anatomy & histology; physiology & pathophysiology; fluid dynamics of lymphatic system
Classroom Practicum 24 Hours client evaluation, Manual & Instrumental Lymph Drainage, hand stroke technique of throat, neck, face, chest

TRAINING SCHEDULE

H-e-a-t LDT50 THERAPY 2
THE ENTIRE BODY TREATMENT TRAINING

MANUAL & INSTRUMENTAL LYMPH DRAINAGE (MLD & ILD)
COMPRESSION THERAPY

TARGET GROUP This training offers didactic and practical instruction of Manual & Instrumental Lymph Drainage designed for physiotherapist, occupational therapist, registered nurse, and skin care specialist.

TRAINING TIME five (5) consecutive days fifty (50) classroom contact hours of theory and practicum, plus thirty (30) home study hours before the start of the classroom training. A home study knowledge content test will be administered on day 1 of the classroom training.

TRAINING PREREQUISITS The didactic and practical instruction of the training is designed for massage therapists, estheticians, and medical and allied health professionals, requiring basic knowledge in anatomy, physiology.

HOME STUDY The text and video will be provided before the training . The training participant is expected to complete 30 hours home study prior to the first day of class. This will develop an extensive knowledge of anatomy, physiology and pathophysiology of the lymphatic system, as it will facilitate a smooth entry and progression of the training.

TRAINING DESCRIPTION The fifty (50) hours classroom training involves hands-on work with application to each body part. The theory covers anatomy and physiology of the lymph vessel system, connective tissue, effects of manual lymph drainage, indications and contraindications. Edema, lymph edema and venous insufficiencies are described with emphasis on how lymph drainage & compression therapy can affect them.

TRAINING OBJECTIVES At the conclusion of the eighty (80) hours training, participant will be able to describe basic principles of anatomy, physiology & pathophysiology of edema lymph edema, the venous system and fluid dynamics of the lymphatic system, recount indications & contraindications for therapeutic intervention, and systemic fluid retention, reproduce the treatment specifics of Manual Lymph Drainage (MLD) (ad modum Vodder & Asdonk, MD), perform full treatment applications of manual lymph drainage & simulated case presentations by regional anatomy of the body, advise clients regarding specifics of ADL, exercise and augmentive therapies (hydrotherapy) and skin care, and become prepared for a subsequent advanced twelve (12) day class room training , covering specifically Compression Physiotherapy (CPT) - lymph drainage & lymph edema hand stroke methods, compression bandaging, garment fitting, remedial exercise procedures & skin care) in the treatment of lymph edema and venous insufficiency edema.

TRAINING PARTICULARS Due to hands-on training time, enrollment is limited to 20. Wear comfortable clothes (sports bra, 2 piece swim suit)

TRAINING CONTENT
Classroom Didactics 10 hours
Home Study Didactics 30 hours the lymphatic and venous systems: anatomy & histology; physiology & pathophysiology; fluid dynamics of lymphatic system
Classroom Practicum 40 hours
Manual Lymph Drainage (MLD) Client evaluation & history, hand-stroke techniques, treatment application of hand stroke patterns by regional anatomy of the entire body.

TRAINING SCHEDULE

H-e-a-t MLDCPT120 THERAPY 3
EDEMA & LYMPH EDEMA TREATMENT TRAINING

MANUAL & INSTRUMENTAL LYMPH DRAINAGE (MLD & ILD) COMPRESSION PHYSIOTHERAPY (CPT)

TARGET GROUP This program offers didactic and practical instruction of Edema-Lymph Edema Management/Manual Lymph Drainage (MLD) & Compression Physiotherapy (CPT) designed for PT, OT, MD, PTA, and RN, MT. This training meets requirements to sit for LANA (Lymphology Association of North America) examination

TRAINING TIME is one hundred twenty (120) classroom contact hours of theory and practicum, lasting twelve (12) consecutive days, plus thirty (30) home study hours before the start of the training. A home study knowledge content test will be administered on the first of the classroom training.

TRAINING PREREQUISITES The didactic and practical instruction of the training is designed for medical and allied health professionals involved in direct patient care This training is suitable for the professions of PT, OT, R.N, MT. State licensed massage therapists * will be considered to enroll in the training with proof that the applicant works under the direct supervision of a physician (M.D., D.O.) or licensed health professional. * Massage therapists much show proof of completion of a minimum 500 hours training program or be certified through the NCBMTB.

HOME STUDY The text and DVD/video will be provided before the training. The training participant is expected to complete 30 hours home study before the first day of class. This will develop an extensive knowledge of anatomy, physiology and pathophysiology of the lymphatic system, as it will facilitate a smooth entry and progression of the training.

TRAINING DESCRIPTION The 120 hours classroom training involves hands on work with application to each body part. Compression Physiotherapy is the most successful treatment for acute and chronic extremity and full body lymph edema. The training participant will be trained in the four components of CPT: 1.Manual lymph drainage hand stroke methodology, 2.Lymphedema hand stroke methodology; lymph quadrant anastomoses), 3. Compression bandaging, garment fitting, compression pump application 4 Skin care.
The training content follows the worldwide accepted treatment standards in edema lymph edema management and compression physiotherapy based on the clinical research and applications set by Vodder, Asdonk, M.D., Fischer, M.D., Foldi, M.D., Kubik, M.D., Partsch, M.D., Puetter, M.D., Van D. Mohlen, M.D., Staudinger, R.N.
Upon completion of this 150-hour training , I am confident that you will return to clinical practice with the means to manage edematous conditions with measurable results.
The training meets requirements to sit for LANA examination (Lymphology Association of North America).

TRAINING OBJECTIVES At the conclusion of the training , participants will be able to 1.describe basic principles of anatomy, physiology/pathophysiology of edema-lymph edema and fluid dynamics of the human lymphatic system, 2. Recount indications/contraindications for physical therapeutic intervention, 3. Differentiate from among varying presenting conditions of edema-lymph edema and systemic fluid retention, 4. Reproduce the specifics of manual lymph drainage ad modum Vodder, Asdonk, MD, Foeldi, MD and edema-lymph edema hand stroke (lymph quadrant anastomoses). Methodology ad modum Foeldi, MD, Asdonk, MD, 5. Perform full treatment applications of manual lymph drainage edema lymph edema hand strokes, apply compression bandages, garments and compression pump treatments in simulated case presentations, by regional anatomy of the body. 6. Advise patients regarding specifics of A.D.L.'s, bandaging, garment fitting, exercise and augmentive therapies and skin care.

TRAINING PARTICULARS Due to hands-on training time, enrollment is limited to 20. Wear comfortable clothes (sports bra, 2 piece swim suit)

TRAINING CONTENT
Classroom Didactics 24 Hours
Home study Didactics 30 Hours
The lymphatic, and venous system: anatomy/histology, physiology/pathophysiology microcirculation fluid dynamics of edema-lymph edema, compression/pressure/fluid dynamics, pathology edema-lymph edema: history & current status medical indications/contraindications patient counseling regarding A.D.L.'s, nutrition, exercise, augmentive therapies.

CLASSROOM PRACTICUM 96 Hours Manual Lymph Drainage (MLD)/Edema & Lymphedema Therapy/Compression Physiotherapy (CPT)
Patient evaluation/history, patient positioning for treatment, hand-stroke techniques, treatment application of hand stroke patterns by regional anatomy, bandaging, compression pump & garment fitting, exercise

TRAINING SCHEDULE

Effects of
MANUAL LYMPH DRAINAGE (MLD),
COMPRESSION BANDAGING, COMPRESSION GARMENTS &
INSTRUMENTAL COMPRESSION PUMP TREATMENT

EFFECTS OF MANUAL LYMPH DRAINAGE (MLD)

Manual Lymph Drainage is an advanced manual therapy technique developed in Europe in the 1930’s by Dr Emil Vodder, native of Denmark. Manual Lymph Drainage is a unique method within the broad framework of classic massage, whereby very light manual strokes stretch the skin to bring about a gentle lymph vessel pumping action in the soft tissue, stimulating the movement of fluids. The gentle, rhythmic, pumping massage movements follow the anatomical direction of lymph flow and produce rapid tissue cleansing results.

Manual Lymph Drainage is used primarily to promote the optimal functioning of the superficial lymph capillaries, vessels, nodes and ducts that lead to the blood circulatory system.

Manual Lymph Drainage facilitates initial lymph vessel and venous capillary actions, which are responsible for carrying excess water, large protein molecules and metabolic wastes from the connective tissue back to the circulatory venous system. During the transportation process the lymph is cleaned, filtered and concentrated and many immune reactions occur in the lymph nodes. If the pathways become congested, blocked, damaged or severed, then fluids can build up in the connective tissue leading to edema. Eventually cell pathology may begin. If there is damage in the connective tissue (e.g. burns, chronic inflammation, ulceration, hematoma), then the lymph vessel system must transport the damaged cells, inflammatory products and toxins away from the area. The quicker this can happen, the faster recovery will occur.
Through the pumping and stretching effect on the lymph vessels, this special Manual lymph drainage method based on Dr. Vodder’s findings and method, stimulates the contraction of lymph vessels, helping lymph fluid to move. Scientific research in Europe for nearly sixty years by Dr’s Vodder, Hutschenreuter, Mislin, Foldi, et al. has made this procedure a well documented therapeutic technique used in the successful treatment of over sixty pathologies.

Manual Lymph Drainage is effective in the treatment of acute and chronic edema (e.g. lymph edema, edemas following strokes and local edemas of traumatic origin such as dislocations, tears and fractures), neuromuscular disorders and facial dysfunction, reflex sympathetic dystrophy, sclerodermas, burns, scar therapy, acne, local chronic inflammations in the respiratory tract (including sinusitis and allergies), periodontal disease, bursitis, carpal tunnel syndrome, migraine, and digestive tract disorders. Used as pre-and post-operative procedure, manual lymph drainage removes congestion and minimizes scar formation. Manual lymph drainage therapy of edematous soft tissue causes skin tissue fluid volume reduction. Subsequent compression therapy with bandages, compression stockings, and pneumomassage is used to preserve the therapeutic success. Compression results in increased tissue pressure with the following consequences: Reduction of abnormally increased ultra filtration into the interstitium. Improved reabsorption from the interstitium. Joint- and muscle pump becomes more effective. Reduction of fibrosis or sclerosis of the interstitium.
Compression results in higher drainage activity –motoricity- of the lymph vessels as well as the initial Lymphatic and lymph capillaries in the epidermis. The extent of these effects depends upon compression pressure, the used compression and the mobility during compression.

EFFECTS OF COMPRESSION BANDAGING

The bandage material used determines the depth of the compression effect on the epidermis or deep regions. Short stretch bandages are primarily used for the compression of cellulite, primary and secondary lymph edema and combination forms, i.e. venous-lymph edema, venous-lipo-lymphedema.
The use of SHORT STRETCH bandages cause high pressure during exercise and general physical activity and relatively low pressure while the body is resting.
An ACE or LONG STRETCH bandage is not as useful for compression because the required bandage pressure results in a disturbed skin perfusion.
SHORT STRETCH bandages, however, allow adequate drainage of the lymphatic fluid, waste ands toxins. The ‘massaging’ effect of the bandages on the tissues underneath can be enhanced by special ‘padding’ foam of high density. Even obstinate connective tissue proliferation can be loosened this way.

EFFECTS OF COMPRESSION GARMENTS

There are four standardized grades of compression garments available to treat cellulite, edema and the various combination forms. For cellulite and post surgery edemas three grades of compression are recommended
Grade1: Superficial effect; ankle pressure 18-21mmHg
Grade2: Medium superficial effect; 25-32 mmHg
Grade3: Superficial & deep tissue effect: 36-46mmHg
Compression stockings/garments are customized following 4-6 weeks of compression drainage therapy-manual lymph drainage, bandaging, exercise, compression pump.
Sufficient long-term therapy vitally depends on the proper adjustment and use of compression stockings/garments. There is no standard formula for the correct adjustment. However, individual differences such as severity and localization of edema, the client’s age and the existence of an additional problem must always be considered.
Exact individual adjustment of the compression garment is an important precondition to achieve optimal wearing comfort. The desired effect can only be achieved with full compliance of the client.

EFFECTS OF INSTRUMENTAL PUMP COMPRESSION

Intermittent pneumatic compression with multiple chamber instruments and pressure built up from distal to proximal has been used in Europe to support and conserve the therapeutic effect of the Combined Compression Therapies.
Instrumental compression-20-80mmHg- has been beneficial to manage peripheral edemas (and cellulite) of the arms and legs, respectively, because of technical reasons. However, pneumomassage of the legs and arms causes the edema to shift into the adjacent trunk quadrant, which must then be treated with manual lymph drainage.
Only recently multi-purpose full body pneumomassage devices have been introduced by the manufacturers of the therapeutic compression extremity pumps widely known for its effectiveness in the treatment of lymphatic and venous disorders.
These compression devices should be peristaltic and should not exceed 80 mmHg compression values, which is the recommended norm for such kind of device. This full body suit, covering the trunk quadrants, performs a peristaltic massage in two stages. The body suit ensures effective and total treatment from ankles to shoulders. The pressure adjustable jacket 20-80 mmHg gives an upper body massage of the arms and shoulders and the pants provide a lower body massage of the legs, thighs, abdomen, hips and buttock, thus accounting for trunk drainage. Comprehensive research by plastic surgeons and physiotherapists has been showing promising results in removal of excess interstitial stagnating fluid accelerating venous and lymph fluid return.
These unique devices have also been very effective in fluid activation in pre-and post liposuction procedure, varicose veins, and cellulite (lipedema) problems.
It is important to continuously evaluate the client’s progress in edema reduction. Since instrumental compression is limited to peripheral edema, it is often necessary to supplement this treatment format with Manual lymph drainage and/or bandaging in order to accomplish optimal results.

Dr Reinhard R Bergel PhD

Dr. Bergel is the president and founder of
H-e-a-t. Inc (Health-enhancement-accessories-training)
Spa Kur Therapy Development.
He is an advisor in Spa Kur facility development and conducts educational workshops and staff training. He has published numerous articles as seen on www.h-e-a-t.com as well as the comprehensive SPA ENCYCLOPEDIA.

He is a founding member of the American Back Society, American Society of Lymphology, American Day Spa Association, and International Medical Spa Association
and has operated a health spa clinic and physical rehabilitation center for almost two decades and founded in 1985 the International Training Institute of Spa Kur Therapy.

He is renowned for his holistic and creative abilities in physical care, rehabilitation, wellness resort and spa services such as exercise-hydro-pelo-thalasso and massage therapy as well as Manual Lymph Drainage (MLD) and Compression Physiotherapy (CPT). He has been practicing and teaching Lymphedema Management since 1986.

Dr. Bergel is from Austria-Germany, where some of the most distinctive medical spas and wellness centers are in use. The Austrian-German Medical Associations and health care insurance system recognize the therapeutic value of these Spa-Kur programs.

Dr. Bergel received degrees from University of Cologne Deutsche Sporthochschule Germany (Exercise Science & Physical Rehabilitation), University of California Los Angeles (Kinesiology) and University of California Berkeley (Education & Exercise Science).

MEMBERSHIPS AND AFFILIATIONS

American College of Sports Medicine
American Back Society
American Society of Lymphology
International Society of Lymphology
International Society of Medical Hydrology
American Day Spa Association
International Medical Spa Association