Title: Revolutionising lymphoedema treatment - A disruptive technology to improve quality of life
Funder: Economic and Social Research Council

Abstract: Proposal: To revolutionise the management of lymphoedema treatment by providing a disruptive technology. Based on the input from leading lymphoedema clinical experts, and feedback from LE patients (user needs); who will also be my collaborators on this project, I developed the following aims: To 1) Provide a more sustainable, affordable, and accessible alternative treatment for LE patients, using a needs-led approach 2) Increase LE awareness. My solution: 1) Deliver the world's first portable PCD device - "LymphMotion"; allowing the patient to frequently self-manage their condition, empowering them to have a higher sense of self-autonomy and improve their quality of life. 2) Work with LE stakeholders to provide outreach workshops and increase awareness of lymphoedema and effective management strategies. The solution: "LymphMotion"; consists of a portable, non-invasive, lightweight, wearable pneumatic compression device (PCD) which mimics manual lymphatic drainage (MLD), that can be used by lymphoedema (LE) patients at home (or at work/holiday) in place of travelling to a specialised clinic for pressure therapy (PCD) or a therapist for MLD. The aim of LymphMotion is to 1) provide a safe, effective, affordable, and convenient at home/away treatment, which 2) alleviates pain and prevent disease progression, and 3) improve the quality of life by allowing the patient to self-manage their condition, providing them with a higher sense of self-autonomy, and 4) reduce the cost of rehabilitation care. LymphMotion would be a novel, innovative, self-managed product designed to be a low-cost disruptive technology compared to competitors. Currently, there exists no such device on the market for lymphoedema, making this a truly innovative, high risk/reward idea that has the potential to significantly impact the wellbeing of LE patients in a positive way, and reduce pressure on the limited health services available. During the Zinc programme, I will 1) develop a working prototype with portable capabilities, with a user-focused iterative design approach by working closely with clinical and patient collaborators, 2) establish a proof of concept, with an aim of achieving a technology readiness level 4, in preparation for acquiring further seed funding for development into a commercial venture (such as Innovate UK, or EIT Health), and bring the concept closer to market; 3) patent application with potential for future IP licensing. 4) Deliver workshops, articles, and podcasts to spread awareness for lymphoedema. Research has shown that early signposting of LE is critical for good prognosis. To maximise my impact beyond academia, I will also deliver outreach workshops and LE awareness campaigns, which are effective ways to increase public knowledge on this health problem. This will be done in collaboration charity groups and IHE (see page 4: network). Mentorship from Prof. Miodownik - who is an expert in public communication, will help with effective dissemination. In the long-term, this campaign can also be used to generate interest in my device. The end goal is to transform this concept into clinical practise: beyond this programme, the future steps once the device is developed and tested, is to secure further funding for development costs and pilot studies with end users. The long-term vision of this project is to revolutionise the treatment of lymphoedema, and increase awareness to the disease. Ultimately improving the healthy living of a growing aging population.

Lay abstract: Clinical problem: Cured of a deadly disease (cancer), but left to survive with a lifelong chronic condition (lymphoedema [LE]). LE is a chronic, progressive, and incurable disease. It is caused by the inability of the lymphatic system (the "plumbing" of the body) to remove fluid from the affected area, resulting in excessive swelling (Fig.1A-B). Risks can include increased age, obesity, and commonly, cancer treatments (e.g., surgery, radiotherapy, chemotherapy). It affects up to 70% of breast, prostate, head and neck cancer patients; they face a lifelong risk of developing lymphoedema, which can manifest from weeks to years after cancer treatment; it is a growing aging challenge and an under-met medical problem. Importance: Growing aging problem with negative impact on quality of life (QoL): with an estimated ~120-250 million individuals globally being affected by LE. It continues to increase with the growing aging population (International Lymphoedema Framework-ILF). It is a leading cause of disability worldwide, yet it remains underdiagnosed, undertreated, under-researched, and underfunded in most healthcare systems, mainly due to lack of awareness from both the public and healthcare professionals (HCP). Lymphoedema patients face huge physical, psychological, and socioeconomic consequences which dramatically reduces their QoL, and significantly affect healthy aging. Physical consequences include: disfigurement, disability, fatigue, pain, excessive swelling. Psychological consequences include: anxiety, depression, decreased self-confidence from distorted body image and loss of independence. Socio-economic consequences include: Huge financial burden (£10K increase in annual treatment), due to the high cost of treatment. (e.g., clinic visits, compression therapy, physiotherapy, several times a week). Lack of productivity due to reduced independence from physical consequences. A new approach is needed: Compression strategies to reduce limb volume such as manual lymphatic drainage (MLD - performed by certified massage therapists), and/or the use of an advanced pneumatic compression device (PCD - delivered at specialist clinics) are critical aspects to treatment, which are viewed as barriers to daily life and described as "terrible daily armour". The lack of an effective way of managing the disease and the inaccessibility of treatment means that this has the most significant effect on patients who are lower income. Proposal: In this project, a new wearable sleeve that is fully portable will be designed, developed, manufactured and tested. The aims of this wearable medical device is to 1) Provide a more sustainable, affordable, and accessible alternative treatment for LE patients, using a needs-led approach 2) Increase LE awareness. My objectives is to : 1) Deliver the world's first portable PCD device - "LymphMotion"; allowing the patient to frequently self-manage their condition, empowering them to have a higher sense of self-autonomy and improve their quality of life. 2) Work with LE stakeholders to provide outreach workshops and increase awareness of lymphoedema and effective management strategies.

Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: CANCER AND NEOPLASMS;INFLAMMATORY AND IMMUNE SYSTEM