1. Massage: a helping hand for people with chronic oedema and lymphoedema.

Pyke C.

http://www.ncbi.nlm.nih.gov/pubmed/20559174

 

Source

British Lymphology Society. Cheryl.Pyke@abm-tr.wales.nhs.uk

Abstract

Skin care is fundamental in maintaining the integrity of one's skin and it has become modern practice to wash and dry ourselves on a daily basis to eliminate odour and rejuvenate the skin. What is becoming more apparent is that as health professionals we are not transferring this basic act to our patient's care and this simple form of neglect can be detrimental to your patient's recovery. Moreover, when washing with the soapy products that are available to us, and then drying ourselves rigorously, we remove our skin's natural oils thus the skin appears drier and is more susceptible to damage. This is where the simple application of a moisturising agent will not only replace the lost oils, but it will in fact stimulate the initial lymphatics lying under your skin. The action of rubbing a cream or emollient into the skin is a form of massage, and this simple action will go a very long way towards the recovery of skin integrity and in the prevention of harm and infection. Make this part of your practice when looking after your patient's wounds and swollen limbs.

PMID: 20559174

[PubMed - indexed for MEDLINE

 

2. Effects of manual lymph drainage on cardiac autonomic tone in healthy subjects.

Kim SJ, Kwon OY, Yi CH.

http://www.ncbi.nlm.nih.gov/pubmed/19922342

 

Source

Department of Physical Therapy, Kangwon National University, Kangwon-do, 245-711, Republic of Korea.

Abstract

This study was designed to investigate the effects of manual lymph drainage on the cardiac autonomic tone. Thirty-two healthy male subjects were randomly assigned to manual lymph drainage (MLD) (experimental) and rest (control) groups. Electrocardiogram (ECG) parameters were recorded with bipolar electrocardiography using standard limb lead positions. The pressure-pain threshold (PPT) was quantitatively measured using an algometer. Heart rate variability differed significantly between the experimental and control groups (p < 0.05), but the PPT in the upper trapezius muscle did not (p > 0.05). These findings indicate that the application of MLD was effective in reducing the activity of the sympathetic nervous system.

PMID: 19922342

[PubMed - indexed for MEDLINE]

 

3. Managing lymphoedema in palliative care patients.

Todd M.

http://www.ncbi.nlm.nih.gov/pubmed/19377392

 

Source

Lymphoedema Clinic, Greater Glasgow and Clyde NHS Trust, Glasgow.

Abstract

The development of lymphoedema in advanced disease is distressing for patients and their carers and can prove difficult to manage for health-care professionals involved in their care. This article will provide an overview of co-morbidities that cancer patients face that will have an impact on the development, progression or management of lymphoedema. The principles of assessing and managing lymphoedema in palliative care patients is presented, based on the Scottish governments action plan Living and Dying Well. The need for collaboration with other members of the multi-disciplinary team to provide the seamless, patient-centred service advocated in this action plan is also presented.

PMID:

19377392

[PubMed - indexed for MEDLINE]

 

4. Patients with venous disease benefit from manual lymphatic drainage.

Molski P, Ossowski R, Hagner W, Molski S.

http://www.ncbi.nlm.nih.gov/pubmed/19367246

 

Source

Department of Orthopaedic and Traumatology, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Poland. molskip@gmail.com

Abstract

AIM:

Manual Lymphatic Drainage (MLD) may increase the quality of life (QoL) of patients with chronic venous disorder (CVD). The aim of the study was to determine the effect of MLD in patients with CVD who were candidates for venous surgery.

METHODS:

Patients with CVD selected for elective venous surgery were randomly divided into 2 groups (N.=20). In the preoperative period, patients in the MLD group underwent MLD 3 times a week for 5 weeks. Patients in the control group did not undergo MLD. Both groups were evaluated for CVD staging on the day of selection for surgery and again 25 days after surgery. CVD staging was evaluated by: HADs (Hospital Anxiety and Depression scale), CEAP classification and Venous Reflux Index (VRI).

RESULTS:

Mean parameter values in the MLD group (before treatment/after MLD/after surgery): Anxiety 12.85/8.85/4.95, Depression 9.40/6.30/3.00, VRI 0.39/0.25/0.17, CEAP 3.60/2.95/1.55. Parameter values in the control group (before treatment/after surgery): Anxiety 10.95/3.45, Depression 7.55/2.20, VRI 0.30/0.10, CEAP 3.55/1.80. In the MLD group there was improvement of QoL (P<0.05) and clinical stage according to the CEAP scale (P<0.05), and VRI (P<0.03).

CONCLUSIONS:

After surgery, the MLD group had significantly better results than the control group in CEAP score (P<0.05) and had comparable results for QoL. MLD improved (P<0.05) VRI, CEAP score, anxiety and depression states. MLD can be an alternative or a supplementary procedure for patients surgically treated.

PMID: 19367246

[PubMed - indexed for MEDLINE]

 

5. The efficacy of manual lymphatic drainage therapy in the management of limb edema secondary to reflex sympathetic dystrophy.

Duman I, Ozdemir A, Tan AK, Dincer K.

http://www.ncbi.nlm.nih.gov/pubmed/19030864

 

Source

Department of Physical Medicine and Rehabilitation, Gulhane Military Medical Academy, Etlik, 06018, Ankara, Turkey. iltekinduman@yahoo.com

Abstract

The objective of this study is to investigate the efficacy of manual lymphatic drainage (MLD) therapy in edema secondary to the reflex sympathetic dystrophy (RSD). A total of 34 patients were allocated randomly into two groups. All of the patients undertook nonstreoidal anti-inflammatory drug, physical therapy and therapeutic exercise program for 3 weeks. Patients in study group undertook MLD therapy additionally. Then the patients continued 2-month maintenance period with recommended home programs. Volumetric measurements pain scores and functional measurements were assessed at baseline, after treatment and 2 months after the treatment. After treatment, improvement in edema was statistically significant in the study group but not in the control group. At follow-up, with respect to baseline, improvements were not significant in both of the groups. Between the groups, difference of the percentage improvements in edema was statistically significant with superiority of MLD group after treatment, but not significant at follow-up. In this pilot study, MLD therapy was found to be beneficial in the management of edema resulted from RSD. Although the long-term results showed tendency towards improvement, the difference was not significant.

PMID: 19030864

[PubMed - indexed for MEDLINE]

 

6. Study of edema reduction patterns during the treatment phase of complex decongestive physiotherapy for extremity lymphedema.

Yamamoto T, Todo Y, Kaneuchi M, Handa Y, Watanabe K, Yamamoto R.

http://www.ncbi.nlm.nih.gov/pubmed/18720915

 

Source

Rhythmic Obstetrics and Gynecology Clinic, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Abstract

Shortening the treatment phase of complex decongestive physiotherapy (CDP) is extremely important both for individual patients and medical economics. In 83 patients with stage II unilateral secondary extremity lymphedema (31 upper extremities and 52 lower extremities), the daily changes in the volume of affected extremities during the treatment phase of CDP were prospectively investigated. For the upper extremity lymphedemas, the biggest change was seen between days 1 (100% residual edema rate) and 2 (46.0 +/- 2.7%; mean +/- SD) of therapy with a 54.0% reduction (p < 0.0001). Between days 2 and 3 (38.0 +/- 2.6%) of therapy, there was an 8.0% reduction (p < 0.05). From days 3 to 6 of therapy, slight changes ranging from 0.2 to 3.2%/day were seen. For the lower extremity lymphedemas, the biggest change was seen between days 1 (100%) and 2 (44.5 +/- 2.1%) of therapy with a 55.5% reduction (p < 0.0001). Between days 2 and 3 (33.5 +/- 2.6%) of therapy, there was an 11.0% reduction (p < 0.001). The daily volume changes from days 4 to 6 were slight, ranging from 0.1 to 1.0%/day. During the treatment phase of CDP, the largest volume changes were seen soon after the start of therapy.

PMID: 18720915

[PubMed - indexed for MEDLINE]

 

7. Lymph drainage in patients with joint immobility due to chronic ulcerated lesions.

Pereira de Godoy JM, Braile DM, de Fátima Guerreiro Godoy M.

http://www.ncbi.nlm.nih.gov/pubmed/18361267

 

Source

Department of Cardiology and Vascular Surgery, São José do Rio Preto University School of Medicine, São Paulo, Brazil. godoyjmp@riopreto.com.br

Abstract

The fibrous process of chronic ulcerated lesions of lower limbs can impair the mobility of the affected limb. The aim of this work was to assess the benefits of lymph drainage in patients who suffer from this disease. Twenty female and five male patients with ages ranging from 53 to 69 years (mean age 60.6 years) were evaluated. All had a history of at least 10 years of varicose veins and/or ulcerated lesions of the lower limbs with initial dermatofibrosis, with the positive Godet sign during the physical examination of the limb. Patients with intermittent claudication, diabetes and trauma were excluded from the study, as well as patients with chronic dermatofibrosis, and in whom positive Godet sign was not seen. Patients with immobility or very limited movement of the ankle and with some limitation in the toe joints were selected. The patients were randomly divided into group A comprising 15 individuals, and group B 10. All the individual treatments were established before the start of the evaluation period. Lymph drainage was performed on the patients of group A four or five times per week. Group B was subjected to a type of massage for the same period and at the same frequency. The mobility of the ankle joints was evaluated using goniometry before the start and after 30 days of treatment. In all the patients who underwent lymph drainage, an improvement of the joint mobility was seen, whereas in the control, group B, there was no obvious change. In conclusion, lymph drainage gave an improvement in the mobility of the ankle joint after impairment due to initial dermatofibrosis in patients with chronic ulcerated lesions.

PMID: 18361267

[PubMed - indexed for MEDLINE]

 

8. Lymphedema: a comprehensive review.

Warren AG, Brorson H, Borud LJ, Slavin SA.

http://www.ncbi.nlm.nih.gov/pubmed/17901744

 

Source

Harvard Medical School, Boston, MA, USA.

Abstract

BACKGROUND:

Lymphedema is a chronic, debilitating condition that has traditionally been seen as refractory or incurable. Recent years have brought new advances in the study of lymphedema pathophysiology, as well as diagnostic and therapeutic tools that are changing this perspective.

OBJECTIVE:

To provide a systematic approach to evaluating and managing patients with lymphedema.

METHODS:

We performed MEDLINE searches of the English-language literature (1966 to March 2006) using the terms lymphedema, breast cancer-associated lymphedema, lymphatic complications, lymphatic imaging, decongestive therapy, and surgical treatment of lymphedema. Relevant bibliographies and International Society of Lymphology guidelines were also reviewed.

RESULTS:

In the United States, the populations primarily affected by lymphedema are patients undergoing treatment of malignancy, particularly women treated for breast cancer. A thorough evaluation of patients presenting with extremity swelling should include identification of prior surgical or radiation therapy for malignancy, as well as documentation of other risk factors for lymphedema, such as prior trauma to or infection of the affected limb. Physical examination should focus on differentiating signs of lymphedema from other causes of systemic or localized swelling. Lymphatic dysfunction can be visualized through lymphoscintigraphy; the diagnosis of lymphedema can also be confirmed through other imaging modalities, including CT or MRI. The mainstay of therapy in diagnosed cases of lymphedema involves compression garment use, as well as intensive bandaging and lymphatic massage. For patients who are unresponsive to conservative therapy, several surgical options with varied proven efficacies have been used in appropriate candidates, including excisional approaches, microsurgical lymphatic anastomoses, and circumferential suction-assisted lipectomy, an approach that has shown promise for long-term relief of symptoms.

CONCLUSIONS:

The diagnosis of lymphedema requires careful attention to patient risk factors and specific findings on physical examination. Noninvasive diagnostic tools and lymphatic imaging can be helpful to confirm the diagnosis of lymphedema or to address a challenging clinical presentation. Initial treatment with decongestive lymphatic therapy can provide significant improvement in patient symptoms and volume reduction of edematous extremities. Selected patients who are unresponsive to conservative therapy can achieve similar outcomes with surgical intervention, most promisingly suction-assisted lipectomy.

Comment in

PMID: 17901744

[PubMed - indexed for MEDLINE]

 

9. Effects of educational program of manual lymph massage on the arm functioning and the quality of life in breast cancer patients.

[Article in Korean]

Lee ES, Kim SH, Kim SM, Sun JJ.

http://www.ncbi.nlm.nih.gov/pubmed/16418566

 

Source

College of Nursing, Chonnam National University, Chonnam Research Institute of Nursing Science, Gwangju, Korea . eslee@chonnam.ac.kr

Abstract

PURPOSE:

The purpose of this study was to determine the effect of EPMLM (educational program of manual lymph massage) on the arm functioning and QOL (quality of life) in breast cancer patients with lymphedema.

METHOD:

Subjects in the experimental group (n=20) participated in EPMLM for 6 weeks from June to July, 2005. The EPMLM consisted of training of lymph massage for 2 weeks and encourage and support of self-care using lymph massage for 4 weeks. The arm functioning assessed at pre-treatment, 2 weeks, and 6 weeks using Arm functioning questionnaire. The QOL assessed at pre-treatment and 6 weeks using SF-36. The outcome data of experimental group was compared with control group (n=20). The collected data was analyzed by using SPSS 10.0 statistical program.

RESULT:

The arm functioning of experimental group was increased from 2 weeks after (W=.224, p=.011) and statistically differenced with control group at 2 weeks (Z=-2.241, p=.024) and 6 weeks (Z=-2.453, p=.013). Physical function of QOL domain increased in experimental group (Z=-1.162, p=.050), also statistically differenced with control group (Z=-2.182, p= .030) at 6 weeks.

CONCLUSION:

The results suggest that the educational program of manual lymph massage can improve arm functioning and physical function of QOL domain in breast cancer patients with lymphedema.

PMID: 16418566

[PubMed - indexed for MEDLINE]

 

10. Massage therapy in the treatment of lymphedema. Rationale, results, and applications.

Bernas M, Witte M, Kriederman B, Summers P, Witte C.

http://www.ncbi.nlm.nih.gov/pubmed/15825847

 

Source

Department of Surgery, University of Arizona, Tucson, Arizona 85724, USA. michaelb@u.arizona.edu

Abstract

The ongoing NCCAM-supported experimental and clinical translational approaches should shed light not only on the physiologic mechanisms underlying the benefits of massage therapy but could also, if successful in defined populations of patients, have a substantial impact by providing a simpler, more cost-effective LE treatment alternative worldwide.

PMID: 15825847

[PubMed - indexed for MEDLINE]