Effects Of Manual Lymphatic Drainage Research Articles

Using noninvasive imaging to assess manual lymphatic drainage on lymphatic/venous responses in a spaceflight analog

This retrospective case series (clinicaltrials.gov NCT06405282) used noninvasive imaging devices (NIID) to assess the effect of manual lymphatic drainage (MLD) on dermal/venous fluid distribution, perfusion, and temperature alterations of the head, neck, upper torso, and legs while in the 6-degree head-down tilt validated spaceflight analog. A lymphatic fluid scanner measured tissue dielectric constant levels. Near-infrared spectroscopy assessed perfusion, by measuring tissue oxygenation saturation. Long-wave infrared thermography measured tissue temperature gradients. Fifteen healthy, university students participated. NIID assessments were taken 1 minute after assuming the HDT position and then every 30 minutes, with MLD administered from 180 to 195 minutes. Subjects returned to the sitting position and were assessed at post-225 min NIID demonstrated significant changes from baseline (p < 0.01), although these changes at areas of interest varied. MLD had a reverse effect on all variables. NIID assessment supported the potential use of MLD to mitigate fluid shifts during a spaceflight analog.

Effects of upper limb low resistance exercises along with manual lymphatic drainage in subjects with post radical mastectomy – a pilot study

Introduction: Post radical mastectomy patients will have physical problems like reduced shoulder movements and upper limb muscles strength. The performance and overall function of upper limb and Quality of Life (QOL) will reduce followed by these muscle’s reduced activity. The aim of present study is to find the effects of manual lymphatic drainage with low resistance training of upper limb on shoulder function and QOL of post mastectomy patients. Generally, upper limb muscles like Trapezius, serratus anterior, pectoralis s group. 1 subject from experimental group withdrawal from study. The treatment duration is 12 weeks based on cancer Rehabilitation principle. Outcome measures are taken Lymph ICF (for QOL), anatomical circumferential measurements (for Lymphedema). Patients selected based on the inclusion and exclusion criteria. Experimental group patients receiving upper limb low resistance training and manual lymphatic drainage techniques and control group patients receiving only manual lymphatic drainage techniques. Both group of patients are advised to wear upper limb elastic stockings for 8 hours per day. Result: All Outcome measures taken in baseline (pre) and end of 12 weeks (post) in both groups. Data was analysed by using paired ’t’ test. Results analysed based on pre and post test values. Conclusion: The study has designed a structured low resistance upper limb exercise program for post radical mastectomy patients in improving shoulder function and QOL.

Effects of Manual Lymphatic Drainage Combined with Press-Release Method Orthopedic Manual Lymphatic Physiotherapy on Upper Extremity Edema and Shoulder Joint Range of Motion and Pain in Patients with Breast Cancer

Effects of Manual Lymphatic Drainage Combined with Press-Release Method Orthopedic Manual Lymphatic Physiotherapy on Upper Extremity Edema and Shoulder Joint Range of Motion and Pain in Patients with Breast Cancer

Manual Lymphatic Drainage vs. Photobiomodulation Therapy for Breast Cancer-Related Lymphedema

In this literature review, I compared the effects of manual lymphatic drainage (MLD) and photobiomodulation therapy (PBMT) in treating breast cancer-related lymphedema (BCRL). I focused on determining which treatment of the two optimized BCRL limb swelling reduction, symptom management, and QOL of patients the most, as well as comparing their minor side effects and potential major risks. There is limited information on the effects of the two treatments on BCRL, but from the information and studies I analyzed, I found that PBMT seems to be a slightly more effective treatment than MLD in the determiners I researched. However, more in-depth research in the future would certainly allow for a more accurate and significant comparison between the two treatments’ efficacy in treating BCRL.

Effects of Manual Lymphatic Drainage with Mobilization and Myofascial Release on Muscle Activities during Dynamic Balance in Adults with Calf Muscle Shortening.

Mobilization with movement (MWM) and myofascial release (MFR) are treatment techniques that increase ankle dorsiflexion range of motion (DFROM). Manual lymphatic drainage (MLD) facilitates waste drainage and improves soft tissue tension in peripheral tissues. To date, no studies have investigated how the combination of MLD, MWM, and MFR influences the human body. The purpose of this study is to determine how the combination of MLD, MWM, and MFR affects DFROM and balance ability. We randomly assigned 16 individuals (26 feet) to one of three groups: MWM-MFR (MR), MWM-MLD (MD), or MWM-MFR-MLD (MRD) intervention. To confirm the intervention effect of each group, DFROM was assessed using a modified lunge test, and dynamic balance was measured using a modified star excursion balance test. In the results, differences were found between the MR and MRD groups in PL and mGCM activities in the 1 section (p = 0.008, p = 0.036) and between the MD and MRD groups in mGCM activity in the 4 and 5 sections (p = 0.049, p = 0.004). We suggest that the application of MRD is the most effective intervention for increasing muscle activation of the PL and mGCM during the modified star excursion balance test.

Effect of a Manual Lymphatic Drainage with Rehabilitation Exercise on Edema, Pain, And Lower Extremity Function in Gynecological Cancer After Surgery

This study aimed to determine the effects of manual lymphatic drainage with rehabilitation exercises on edema, pain, and lower extremity function in patients with gynecological cancer after surgery. The study included 20 patients with gynecological cancer with a Numeric Rating Scale (NRS) pain score &gt;3, who were either inpatients or outpatients in Seoul. The patients were randomly assigned to either the experimental group (n=10) or control group (n=10). The experimental group underwent manual lymphatic drainage with rehabilitation exercises, whereas the control group underwent manual lymphatic drainage with diaphragmatic breathing. Each patient was treated for 50 min twice a week for 4 weeks. Before and after the experiment, edema, pain, lower extremity function, and quality of life were evaluated using the Circumference Tape, Numeric Rating Scale, Lower Extremity Functional Scale, and Memorial Symptom Assessment Scale. The results of this study were as follows. First, the edema between the experimental and control groups significantly decreased before and after the intervention; however, there was no significant difference in the comparison between the groups. Second, the pain scores between the experimental and control groups significantly decreased before and after the intervention, and there was a significant difference in the comparison between the groups. Third, the lower extremity function between the experimental and control groups significantly increased before and after the intervention, and there was no significant difference between the groups. Forth, the quality of life between the experimental and control groups significantly increased before and after the intervention, and there was significant difference in the comparison between the group. The physical symptoms were significantly different between the groups; however, the emotional symptoms were not. The analysis of this experiment showed that, both the groups were effective in improving edema, pain, lower extremity function, and quality of life in patients with gynecological cancer undergoing surgery. In particular, manual lymphatic drainage with rehabilitation exercises was more effective than manual lymphatic drainage with diaphragmatic breathing for edema and physical symptoms of patients with gynecological cancer after surgery.

Effects of manual lymphatic drainage on total knee replacement: a systematic review and meta-analysis of randomized controlled trials

BackgroundTotal knee joint replacement (TKR) is an effective method for the treatment of severe knee osteoarthritis. With an increasing number of surgeries, complications such as lower limb edema, pain, and limited mobility have caused a heavy burden. Manual lymphatic drainage (MLD) may be a solution to solve the problem. The study aims to evaluate the efficacy of MLD in reducing knee edema, pain, and improving range of motion (ROM) in patients after TKR.MethodsA search was conducted in PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIPs, WanFang database, and Google Scholar from inception to June 2023. Only randomized controlled trials (RCTs) that compared the effects of MLD and non-MLD (or another physiotherapy) on improving knee edema, pain, and ROM after TKR were included. Stata 16.0 was used for meta-analysis. GRADE was used to assess the quality of evidence.ResultsIn total, 7 RCTs with 285 patients were identified. There were no significant differences found in the ROM of knee flexion (standardized mean difference (SMD) = 0.03, 95% confidence interval (CI): -0.22, 0.28, P = 0.812) and the ROM of knee extension (SMD= -0.30, 95%CI: -0.64, 0.04, P = 0.084). No differences were observed in the lower extremity circumference after TKR (SMD= -0.09, 95%CI: -0.27, 0.09, P = 0.324). For postoperative pain, there was no significant advantage between the MLD and non-MLD groups (SMD= -0.33, 95%CI: -0.71, 0.04, P = 0.083).ConclusionsBased on the current evidence from RCTs, manual lymphatic drainage is not recommended for the rehabilitation of patients following total knee replacement.

Comparative effects of lymphatic drainage and soft tissue mobilization on pain threshold, shoulder mobility and quality of life in patients with axillary web syndrome after mastectomy

PurposeThe purpose was to compare the effects of manual lymphatic drainage and soft tissue mobilization on pain threshold, shoulder mobility and quality of life in patients with axillary web syndrome.MethodsThis randomized clinical trial was conducted on 36 breast cancer patients with developed axillary web; participants were randomly divided into two groups. One group was treated with manual lymphatic drainage; the other group was treated with soft tissue mobilizations in addition to therapeutic exercises, i.e., stretching, strengthening and range of motion (ROM) exercises. The duration of treatment was four weeks (5 sessions/week), with therapeutic exercises as a common treatment protocol. Outcome measures were Breast-Cancer specific quality of life questionnaires, Disabilities of the Arm, Shoulder and Hand (DASH), Numeric Pain Rating Scale (NPRS), Patient Specific Functional Scale (PSFS), Dynamometer and Goniometer. All outcome measure readings were recorded at baseline and the end (4th week) of the treatment.ResultsThe compliance of the variable distribution with normal distribution was verified using the Shaphiro-Wilk test. Parametric tests were applied, and both groups showed significant effects (p < 0.05) in pairwise comparison (paired t-test). The comparison group analysis (independent t-test) showed that there was no significant difference in pain, upper limb strength, range of motions and fatigue component of quality of life questionnaire parameters (p > 0.05). Two parameters (DASH, PSFS) and one component of the quality of life questionnaire (global health) showed a significant difference (p < 0.05).ConclusionManual lymphatic drainage showed more improvement in functional movements. It was concluded that both groups, manual lymphatic drainage and soft tissue mobilization groups were clinically equally effective.Trial Registration NumberThis trial is registered at ClinicalTrial.gov PRS under trial number NCT05463185 on date 18/07/2022.

Does manual lymphatic drainage improve upper extremity functionality in female patients diagnosed with rheumatoid arthritis? A randomized controlled study.

To demonstrate the effect of manual lymphatic drainage (MLD) on upper extremity functionality in patients with rheumatoid arthritis (RA). Thirty-nine female patients diagnosed with RA who were in remission were included in the study. The study group included 19 participants (mean age 50.63 ± 9.83 years), the control group included 20 participants (mean age 55.05 ± 5.89 years). The patients were randomized into two groups as home exercise program plus MLD and home exercise program alone. Both groups received treatment for 4 weeks. The primary outcome measure was pressure pain threshold (PPT). The patients were evaluated using the PPT, visual analog scale (VAS), hand-wrist joint range of motion examination, hand dynamometer and pinchmeter measurements, and the Rheumatoid Arthritis Quality of Life Scale before the interventention and at the end of the 4th week. The PPT evaluated at the thumbnail, wrist, and trapezius significantly increased in the study group after treatment (p < .001, p = .001, and p < .001, respectively). MLD was found to significantly increase the PPT at the thumbnail compared with home exercise program (p = .047). The VAS score significantly decreased in the study group (p = .011). The level of increase in radial deviation was statistically higher in the study group (p = .004). Manual lymphatic drainage had a positive effect on pain, PPT, and range of motion in RA patients in remission. MLD can be added to medical and other conservative treatments in RA patients.

Effect of Manual Lymphatic Drainage on the Concentrations of Selected Adipokines, Cytokines, C-Reactive Protein and Parameters of Carbohydrate and Lipid Metabolism in Patients with Abnormal Body Mass Index: Focus on Markers of Obesity and Insulin Resistance.

The aim of the study was to assess the impact of manual lymphatic drainage (MLD) on the parameters of carbohydrate metabolism, lipid metabolism and the level of selected adipokines and cytokines in people with abnormal body mass index (BMI). In addition, an attempt was made to assess the optimal cut-off values of serum concentrations of the biochemical parameters studied in identifying the risk of obesity and insulin resistance (IR). The study included 60 subjects who underwent 10 and 30 min long MLD sessions three times a week. The study group included 15 patients with a normal body mass index (group I; n = 15), overweight patients (group II; n = 15) and obese patients (group III; n = 10). The control group was IV; n = 20 subjects not undergoing MLD. Biochemical tests were carried out on all subjects at stage 0' (before MLD therapy) and at stage 1' (one month after MLD therapy). In the control group, the time between the sample collection at stage 0' and stage 1' was the same as in the study group. Our results showed that 10 MLD sessions may have a positive effect on the selected biochemical parameters, including insulin, 2h-PG, leptin and HOMA-IR values in normal weight and overweight patients. In addition, in the study group, the highest AUCROC values in identifying the risk of obesity were found for leptin (AUCROC = 82.79%; cut-off = 17.7 ng/mL; p = 0.00004), insulin (AUCROC = 81.51%; cut-off = 9.5 µIU/mL; p = 0.00009) and C-peptide (AUCROC = 80.68%; cut-off = 2.3 ng/mL; p = 0.0001) concentrations as well as for HOMA-IR values (AUCROC = 79.97%; cut-off = 1.8; p = 0.0002). When considering the risk of IR, we observed the highest diagnostic value for insulin (AUCROC = 93.05%; cut-off = 1.8 ng/mL; p = 0.053), which was followed by C-peptide (AUCROC = 89.35%; cut-off = 17.7 ng/mL; p = 0.000001), leptin (AUCROC = 79.76%; cut-off = 17.6 ng/mL; p = 0.0002) and total cholesterol (AUCROC = 77.31%; cut-off = 198 mg/dL; p = 0.0008). Our results indicate that MLD may have a positive effect on selected biochemical parameters, including insulin, 2h-PG, leptin and HOMA-IR, in normal weight and overweight patients. In addition, we successfully established optimal cut-off values for leptin in the assessment of obesity and insulin in the assessment of insulin resistance in patients with abnormal body mass index. Based on our findings, we hypothesize that MLD, when combined with caloric restriction and physical activity, may serve as an effective preventive intervention against the development of obesity and insulin resistance.

The Effect of Manual Lymph Drainage and Compression Bandaging for Stage 2 Breast Cancer-Related Lymphedema: A Randomized Controlled Trial.

Aim: To explore the effect of manual lymph drainage (MLD), compression bandaging (CB), or combined decongestive therapy (CDT), including MLD and CB, on stage 2 breast cancer-related lymphedema (BCRL). Methods: Sixty women with stage 2 BCRL were enrolled. They were randomly divided into the MLD group, the CB group or the CDT group. Each group, respectively, received MLD alone, CB alone, or CDT composed of MLD and CB, for 2 weeks. The volume and the local tissue water (LTW) of affected arms were measured before and after treatment. Arm circumferences were measured at 4 cm interval starting from the wrist to the shoulder with a tape measure. LTW was detected using the (tissue dielectric constant, TDC) method and was expressed as TDC value in two sites on the ventral midpoint of upper arm and forearm. Results: The volume of affected arms in each group after 2-weeks' treatment was lower than their baseline and the difference was statistically significant (p < 0.05). But there was no significant difference in volume change among three groups. The TDC value of the upper arm and forearm in the group CB and the group CDT decreased distinctly compared with baseline (p < 0.05). But the TDC value of the upper arm and forearm after MLD did not change (p > 0.05). Compared with the group MLD and the group CDT, the reduction of the TDC value in the group CB was more significant (p < 0.05). Conclusions: MLD or CB alone could effectively reduce the volume of affected arms for patients with stage 2 BCRL, and CB also could reduce the LTW more significantly. CDT did not seem to show an extra advantage. Therefore, CB may be the first choice for stage 2 BCRL. But for patients who are unwilling or intolerant to CB, MLD can be selected.

OC-0767 Effect of manual lymph drainage in people with breast cancer-related lymphedema: EFforT-BCRL trial

OC-0767 Effect of manual lymph drainage in people with breast cancer-related lymphedema: EFforT-BCRL trial

Effect of manual lymphatic drainage combined with targeted rehabilitation therapies on the recovery of upper limb function in patients with modified radical mastectomy: A randomized controlled trial.

This study aimed to evaluate the effect of manual lymphatic drainage (MLD) combined with targeted rehabilitation therapies on the recovery of upper limb function in patients with breast cancer after modified radical mastectomy. In the randomized controlled study conducted between October 2019 and June 2020, 104 eligible breast cancer patients who underwent modified radical mastectomy were randomly divided into two groups. The routine functional exercise group (Group RF) received regular functional exercise guidance. In addition, the MLD combined with targeted rehabilitation therapies group (Group MLDT) received MLD, targeted rehabilitation therapies, and regular functional exercise guidance. The primary endpoints were shoulder range of motion, arm circumference and the incidence of axillary web syndrome (AWS). The secondary endpoints included the duration of axillary drainage, the duration of chest wall drainage, and complications. One hundred participants (mean age: 51.9±8.0 years; range, 28 to 72 years) were included in the final analysis as four patients could not complete the study. A significant improvement in shoulder range of motion was observed in Group MLDT compared to Group RF (p<0.05). Additionally, in Group MLDT, the duration of chest wall drainage was reduced (p=0.037). The frequency of AWS in Group RF was twice that in Group MLDT (p=0.061), but there was no significant difference in arm circumference (p>0.05) or the duration of axillary drainage (p=0.519). Regarding complications, there was one case of necrosis in the MLDT group and four cases in the RF group, including wound infection and seroma. Manual lymphatic drainage combined with targeted rehabilitation therapies is an effective strategy to improve shoulder function, shorten the duration of chest wall drainage, reduce complications, and partly lower the incidence of AWS.

Соmplex Medical Rehabilitation for Cancer-related Lower Limbs Lymphedema: a Prospective Comparative Randomized Study of 60 Patients

INTRODUCTION. The management of patients with secondary lymphedema of the lower extremities associated with radical treatment of pelvic cancer (Cancer Related Lymphedema) is extremely problematic due to persistent impairment of the draining function of regional lymph nodes due to intraoperative dissection and subsequent radiation therapy. AIM. To compare the effectiveness of complex medical rehabilitation using the kinesio taping method and innovative non-stretchable compression bandages in patients with secondary lymphedema of the lower extremities associated with radical treatment of pelvic cancer. MATERIAL AND METHODS. The study involved 60 patients with stages I-III Cancer Related Lymphedema (according to the classification of Savchenko T.V., Pokrovsky A.V., 2004) who underwent radical treatment for various forms of pelvic cancer (gynecological cancer in women and prostate cancer in men), randomized into 2 groups (30 people each). A comprehensive rehabilitation was carried out in the main group (n=30), including sequential manual lymphatic drainage, skin care, kinesio taping, therapeutic gymnastics in the gym; Adjustable Non-stretchable Compression Bandages (circaid juxtafit, Germany). Meanwhile, a Complex Decongestive Therapy was performed in the comparison group (n=30), which is considered as the gold standard of conservative treatment of lymphedema of the lower extremities, including manual lymphatic drainage, skin care, Multi-layered limb banding using Inelastic compression Bandages. In order to evaluate the anti-edematous effect the dynamics of the circumferences of the lower extremities, waist circumference and hip circumference, the Ankle Range of Motion were examined using goniometry, bio-impedancemetry. Laser Doppler Flowmetry was used to evaluate microcirculatory parameters. RESULTS AND DISCUSSION. There was a decrease in swelling and thickening of the skin in the thigh, a decrease the external genitalia edema in patients with Cancer Related Lymphedema in both groups after a course of rehabilitation. There was a regression of swelling of the feet and lower legs in patients of both groups (p&lt;0.05) after treatment, which was confirmed by a decrease in the circumferences of the lower limbs. There was an increase in the Ankle Range of Motion (dorsiflexion) from 17.50±1.26° to 19.25±1.52° (p&lt;0.05) in the main group and from 17.90±1.44° to 18.59±1.10° (p&lt;0.05) in the comparison group. According to the bio-impedancemetry data, there was a decrease in the extracellular fluid content both in the main group and the comparison group by 2.64% and 2.83%, (p&lt;0.05) respectively. There was also a comparable decrease in the total fluid content by 2.67% in the main group and 1.90% (p&lt;0.05) in the comparison group. There were a decrease in body weight by 2.49% and 1.52% (p&lt;0.001), a decrease in fat mass by 2.62% and 4.01% (p&lt;0.05) in both groups respectively after the course of treatment. According to the Laser Doppler Flowmetry data, there were an improvement in the indicators of myogenic tone of arterioles and secretory activity of the endothelium, as well as elimination of venular congestion in patients of both groups (p&lt;0.05). CONCLUSION. Regression of edema in Cancer Related Lymphedema can be achieved as a result of the use of manual lymphatic drainage which stimulates the outflow of lymph through lymphatic watersheds into adjacent lymphatic territories with intact regional lymph nodes, which was achieved in both groups. The lymphatic drainage effect of manual lymphatic drainage was supported by the daily compression profile of bandages (Multi-layered Inelastic Bandages and Adjustable Non-stretchable Compression Bandages) in patients of both groups. Our study showed that the use of kinesio tapes leveled the difference in compression of approximately 10-15 mmHg between the bandages used (50 mmHg/~60 mmHg).

Acute Effects of Manual Lymphatic Drainage and Compression with Exercise Therapy on Breast Lymphedema Following Breast-Conserving Surgery and Radiotherapy.

Background: Breast lymphedema is a common complication of breast cancer treatments but there are limited studies about the treatment of breast lymphedema. The aim of this study was to investigate the acute effects of manual lymphatic drainage (MLD), compression with exercise on the local tissue water percentage, pain, and stiffness following breast-conserving surgery and radiotherapy. Materials and Methods: Twenty-two patients (52.54 ± 12.18 years, 28.55 ± 5.11 kg/m2) were included. The sociodemographic and clinical information was recorded. The pain and stiffness severity were measured with Visual Analog Scale. Measurements of water percentages in local tissue were performed in all quadrants of the breast with the Moisture Meter D Compact device. All measurements were performed baseline, after MLD, and after compression with exercise. Results: There was a significant difference in local tissue water percentages between the affected and unaffected sides before treatment. The percentage of water only in the lower outer quadrant of the affected breast increased significantly after acute treatment (p: 0.002). In addition, pain (p: 0.001) and stiffness (p: 0.001) scores decreased. Conclusions: Local tissue water percentages increased with MLD and decreased with compression with exercise. In the treatment of breast lymphedema, MLD and compression bandage with exercise may be beneficial in the management of the symptoms of swelling, pain, and stiffness.

Effect of manual lymphatic drainage on upper limb lymphedema after surgery for breast cancer

Evaluation of the effect of manual lymphatic drainage on lymphedema of the upper limb after previous axillary lymphadenectomy/sentinel node bio-psy during the maintenance phase of lymphedema after the breast cancer surgery. A total of 30 patients after surgical treatment of unilateral breast cancer underwent 10 manual lymphatic drainages within 8 consecutive weeks. All patients underwent upper limb circumference measurements before and after the study and completed two specialized EORTC questionnaires (QLQ-C30 and QLQ-BR23). The average time between surgery and admission into this study was 32.5 months. In the beginning of the study, lymphedema was present for an average of 19.8 months. At the end of a series of manual lymphatic drainages, the average volume decrease of the limb with lymphedema was 3% (1.5-5.6%). In contrary, the average loss of volume on the healthy (control) upper limb was only 0.4%. The average reduction of lymphedema volume after therapy achieved 57% (37-88%). After a series of manual lymphatic drainages, the results of the EORTC QLQ-C30 questionnaire showed a statistically significant improvement in physical and role functions, fatigue, nausea and vomiting, pain, dyspnea and constipation, while the results of the EORTC QLQ-BR23 questionnaire showed a statistically significant improvement in the arm and breast symptoms. There was no statistically significant deterioration in any of the monitored parameters. The results of the study showed a positive effect of manual lymphatic drainage on the maintenance phase of lymphedema in patients after breast cancer surgery. The questionnaires showed a significant improvement in hand and arm symptoms as well as an improvement of the other functions and symptoms affecting quality of life. Further studies should be performed on groups of patients with the maintenance phase of upper limb lymphedema to confirm or disprove our results.

Significant Decrease in Glycated Hemoglobin, 2h-Post-Load Glucose and High-Sensitivity C-Reactive Protein Levels in Patients with Abnormal Body Mass Index after Therapy with Manual Lymphatic Drainage.

The objective of this study was to investigate the effect of manual lymphatic drainage (MLD) on the insulin resistance parameter (HOMA-IR), glycated hemoglobin (HbA1c), C-peptide, insulin, fasting plasma glucose (FPG), 2h-post-loadglucose (2h-PG) and the concentration of high-sensitivity C-reactive protein (hsCRP) in patients with abnormal body mass index. The study involved 30 patients, including patients with normal body weight (as a control group; group I; n = 14), overweight patients (group II; n = 9) and obese patients (group III; n = 7). Each patient underwent 10 sessions of MLD therapy, 3 times a week for 30 min. In addition, we measured body mass index (BMI) and waist-to-hip ratio (WHR) and performed body composition analysis as well as biochemical tests before MLD therapy (stage 0′) and after MLD therapy (stage 1′). A statistically significant correlation was demonstrated between the concentration of C-peptide, BMI, the amount of visceral adipose tissue (r = 0.87, p = 0.003; r = 0.76, p = 0.003, respectively), and the HOMA-IR index, BMI and the amount of visceral adipose tissue (r = 0.86, p = 0.005; r = 0.84, p = 0.042, respectively), before and after MLD therapy. In overweight patients (group II), a statistically significant (p = 0.041) decrease in the hsCRP level by 2.9 mg/L and a significant (p = 0.050) decrease in the 2h-PG level by 12 mg/dL after the MLD therapy was detected. Moreover, in the group of obese patients (group III), a statistically significant (p = 0.013) decrease in HbA1c level by 0.2% after MLD therapy was demonstrated. Our results indicate that MLD may have a positive effect on selected biochemical parameters, with the most favorable changes in overweight patients. Further studies in a larger number of patients are warranted to confirm our findings, to test in-depth their mechanism, and to investigate clinical benefits of this alternative therapy in patients with abnormal body mass index.

Effect of manual lymphatic drainage combined with vacuum sealing drainage on axillary web syndrome caused by breast cancer surgery.

The aim of the study was to explore the application value of manual lymphatic drainage combined with vacuum sealing drainage in axillary web syndrome (AWS) after breast cancer surgery. From 1 April 2020 to 1 June 2020, a total of 102 patients with AWS after axillary lymph node biopsy or axillary lymph node dissection in our hospital were included in this prospective study. According to the random number table method, all patients were divided into the study group (n=51) and the control group (n=51). The study group received the treatment of manual lymphatic drainage combined with vacuum sealing drainage, and the control group received health education and the treatment of functional training. The efficacy observation indicators included duration time to the disappearance of relevant clinical symptoms, degree of pain, angle of abduction of the affected limb, degree of upper limb disability function and quality of life. The duration time to the disappearance of cord-like nodules and tightness in the study group was both significantly shorter than that in the control group (both P < .05). In the time point of 1 and 3 months after the intervention, compared with that in the control group, the study group had a significantly lighter degree of pain, a better degree of upper limb disability function and higher quality of life (all P < .05). Manual lymphatic drainage combined with vacuum sealing drainage can shorten the disappearance time of relevant clinical symptoms, relieve the degree of pain, improve the upper limb disability function and improve the quality of life in patients with AWS.

Effect of Manual Lymphatic Drainage on Breast Cancer-Related Postmastectomy Lymphedema: A Meta-analysis of Randomized Controlled Trials.

Manual lymphatic drainage (MLD) is widely used in the treatment of breast cancer-related postmastectomy lymphedema (BCRL). However, the therapeutic benefit of MLD on BCRL remains controversial. The aim of this study was to analyze the efficacy of MLD for BCRL. Four electronic databases were systematically searched for trials comparing MLD and no MLD treatment as options for BCRL. Comparative treatment results included reduction of upper extremity limb volume with subgroup analysis by the number and duration of treatments. A total of 457 patients were included in the analysis. There was no significant difference in the amount of upper extremity edema between the MLD treatment and control or no MLD groups ( P = .11). However, when the treatment course was ≥20 sessions, there was a significant reduction in the upper extremity volume ( P = .03). There was also a significant reduction in the upper extremity volume when treatment duration was >2 weeks ( P = .03). Manual lymphatic drainage treatment statistically did not reduce the upper extremity limb volume of BCRL, but upper extremity volume was reduced at statistically significant levels when treatment number were ≥20 sessions or the duration of treatment was >2 weeks. Reduction in upper limb volume is dependent on the number and duration of treatments. When treatment number were ≥20 sessions, or the duration of treatment was >2 weeks, reduction of upper limb volume was statistically achieved. Manual lymphatic drainage treatment can be clinically recommended to treat BCRL according to these parameters.

The effect of manual lymphatic drainage on postoperative recovery process following total knee arthroplasty

Background: Knee joint has great importance on daily living activities thus gonarthrosis does affect quality of life of patients very dramatically. Total knee arthroplasty (TKA) is accepted as gold standard in order to cope with pain, deformity and instability especially in patients with gonarthrosis who are in terminal stage. Physical therapy and rehabilitation programs are known to increase the success of this surgical procedure. As edema around knee joint is one of the major postoperative complications, which prolong recovery process, it is important to use therapeutic modalities against this problem.&#x0D; Objective: In this study it was aimed to evaluate the effectiveness of manual lymphatic drainage (MLD) following TKA on edema, range of motion, pain, independence of daily living activities, gait distance and knee functionality.&#x0D; Material and Method: 16 patients with TKA were divided into two groups while one of them is applied standard postoperative rehabilitation procedure (exercise therapy, cryotherapy and positioning) and the other group had MLD therapy on the second and fourth days of the postoperative process for thirty minutes and in one session during the day in addition to standard protocol. On post-op 2nd, 4th, and 6th days, the volumetric changes were calculated based on a formula of Sitzia et al. for each 4 cm segment of the lower extremity, active ROM and knee posture at rest were measured by a universal goniometer, pain by using visual analog scale (VAS), walking distance by calculating total walking distance in a day, independence level in daily living activities by using Functional independence measurement (FIM) scale. In addition, Lysholm knee score was calculated on postoperative 15th day in order to evaluate functionality of knee joint.&#x0D; Results: At postoperative 2nd day, 4th day and 6th day, the mean of FIM (p=0.972, p=0.575, p=0.398, respectively), active ROM (p=0.288, p=0.522, p=0.622, respectively), knee posture (p=0.870, p=0.521, p=0.445, respectively), gait distance (p=1.000, p=0.258, p=0.113, respectively), volume of the operated lower extremity (p=0.451, p=0.384, p=0.268, respectively), VAS for pain daytime (p=0.192, p=0.488, p=0.506, respectively) and night (p=0.137, p=0.562, p=0.748, respectively) were similar in both MLD and non-MLD groups. The mean of Lysholm score was 46.25±24.50 in MLD group and 61.12±17.70 in non-MLD group (p=0.186).&#x0D; Conclusion: Although there is no significant difference between groups, the effectiveness of MLD can be showed in studies which will be performed with a larger sample size.