Effectiveness Of Manual Lymphatic Drainage Research Articles

Effectiveness of manual lymphatic drainage in women with fibromyalgia: A pilot study

BackgroundCurrently there is no treatment capable of significantly alleviating all the symptoms of fibromyalgia (FM), even though it is a complex syndrome with a high prevalence in the population. DesignExperimental study using a single-blind, randomised, clinical trial. ObjectiveTo analyse the efficacy of manual lymphatic drainage (MLD) as an alternative to traditional treatment of fibromyalgia (FM) in women. MethodsThis was an experimental study using a single-blind, randomised, clinical trial of 20 women between 30 and 55 years old with FM. Patients were divided into an experimental group (n = 10) and a control group (n = 10). During the study, 3 measurements of pain (visual analogue scale and algometry), FM impact (Fibromyalgia Impact Questionnaire), sleep quality (Index Pittsburgh), anxiety and depression (Hospital Anxiety and Depression Scale) were recorded. Treatment of the experimental group consisted of 2 weekly MLD sessions for 6 weeks. ResultsThe effect of the interaction of MLD showed statistically significant results in Right intercostal space (F2,36 = 3.54; p = 0.04; n2p = 0.16). The sleep quality was significantly better favour of the treatment (F2,36 = 4.16; p = 0.01; n2p = 0.20). ConclusionsMLD therapy demonstrated effects in the experimental group in contrast to the control group across the intervention period concerning the right intercostal space and sleep-related factors. However, MLD did not result in observable alterations in pain perception.

Effectiveness of manual lymphatic drainage in intensive phase I therapy of breast cancer–related lymphedema—a retrospective analysis

BackgroundThe standard therapy for lymphedema of any origin is complex physical decongestive therapy (CDT). It comprises manual lymph drainage (MLD), compression therapy (CT), exercise therapy (ET), skincare, and patient education. Additionally, intermittent pneumatic compression (IPC) can be applied. However, the contribution of MLD to decongestion is repeatedly questioned.Patients and methodsThis study re-analyzes a previous study during a 3-week decongestion period, comparing two different types of compression bandaging at the weekend. Sixty-one patients with unilateral breast cancer–related lymphedema were included. The patients received the same therapy (CDT + IPC) except for the different weekend compression bandaging. MLD was performed twice a day on weekdays. The volume of the affected arm was measured on days 1, 5, 8, 12, 15, 19, and 22. For the analysis, the data of both study groups were pooled.ResultsDuring the week, the patients showed a significant volume reduction (− 155.23 mL (week 1), − 101.02 mL (week 2), − 61.69 mL (week 3), respectively; p < 0.001 each) with a high effect size. On the weekends without MLD, they showed a slight, but also significant increase (12.08 mL (weekend 1), 8.36 mL (weekend 2), 4.33 mL (weekend 3), respectively; p < 0.001 each) with a medium effect size.ConclusionsWe showed a strong effect of MLD on volume reduction. Differences from other studies are the larger study population and the more intensive application of MLD. If applied intensively, MLD is strongly decongestive during a 3-week decongestion therapy for breast cancer–related lymphedema.

Effectiveness of manual lymphatic drainage and intermittent pneumatic compression in lymphedema maintenance therapy.

Background: To compare the effectiveness of intermittent pneumatic compression (IPC) and/or manual lymphatic drainage (MLD) associated to compression stockings in the maintenance treatment of lymphedema. Patients and methods: Patients in the maintenance phase of lymphedema therapy with MLD and compression since more than a year with stable values for weight and circumferences of ankle and calf were asked to participate in a study: Compression had to be worn daily, (1) 4 weeks IPC+MLD, (2) 4 weeks MLD alone, (3) 4 Weeks IPC alone (Order 1 and 3 was randomized). At the beginning and after each 4 weeks, circumference measurements (by hand and by machine: BT600®, Bauerfeind) were documented, pain and discomfort were assessed, and quality-of-life questionnaires were completed. Results: Of 20 participants, 18 (14 female, 4 male), mean age 59.6 years (48-89) could be evaluated. 11 subjects had bilateral, 7 unilateral, 5 primary, 13 secondary lymphedema since 2-20 years (mean 7.7), the subjects had received MLD and compression for 2-14 years (mean 6.4), 1-3 times per week (mean 1.5). The BMI ranged between 21 and 47 (mean 33.7). No differences between any phases were found for: Calf and thigh volume, circumference of calf. Only the ankle circumference was significant less (-0.22cm) when using "both" (IPC+MLD). Compared to before the study, quality of life was better in all three phases, but with a significantly higher improvement in the phases with IPC than in the phases without. Conclusions: There were no differences in objective measurement between MLD alone, IPC alone or both, excepting the minimal significant difference in ankle circumference after IPC+MLD. QOL favored IPC application. Considering the economic consequences of these results, a change of maintenance therapy with MLD weekly over years in favor of permanent care with IPC and few appointments of MLD per year should be considered and further investigated.

도수림프배출법이 림프절 절제술을 받은 부인암 환자의 하지 기능, 림프부종, 통증에 미치는 효과

This study was an experimental study that evaluate the effectiveness of manual lymphatic drainage(MLD) on lower extremities function, lymphedema and pain in gynecologic cancer patients after surgery with pelvic lymph node dissection. The experiment was conducted on 20 gynecologic cancer patients with a numeral rating scale(NRS) pain score of >3 treated 2 times a week for 4 weeks. This study used one-group pretest-posttest design and the leg function(LEFS), leg volume, pain(NRS) was implemented for 20 patients. Patients was perfoshowed statistically significant differences in all the three items after implementing a LEFS score, leg volume, NRS score between the pre-post scores(p<.05). The study found that the leg function, leg volume, pain were significantly improved in gynecologic cancer patients after surgery with lymph node dissection after the 4-week intervention(p<0.05). This study might be useful for further studies that proves the necessity and importance of the manual lymphatic drainage(MLD) treatment in gynecologic cancer after surgery with lymph node dissection

Effectiveness of manual lymphatic drainage for breast cancer-related lymphoedema: an overview of systematic reviews and meta-analyses

There are several studies on the treatment of breast cancer-related lymphedema (BCRL) based on the manual lymphatic drainage (MLD) technique, making it a widely accepted conservative treatment for BCRL. In this study, PubMed, Embase and Cochrane Library databases were searched for systematic reviews (SRs) or meta-analyses (MAs) from inception till 28 March 2022. The methodological quality of the included SRs/MAs was evaluated using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), and the evidence quality of outcome measures using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Grading of Recommendations, Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) was used to describe the certainty of evidence from qualitative data. The study results identified 7 eligible SRs/MAs. Evaluation using AMSTAR-2 revealed only one moderate quality study, while the others were rated as low or critically low. The GRADE criteria identified 3 very-low-quality evidence studies, 1 low-quality evidence study, and 9 moderate-quality evidence studies. The GRADE-CERQual assessment showed the confidence for decision-making was either low or moderate. Overall, the results indicated that MLD could significantly reduce lymphedema in patients aged &lt;60 years (standard mean difference (SMD): −1.77, 95% confidence interval (CI): (−2.23 to −1.31)), and the optimal intervention duration was 1 month. Although MLD for BCRL might reduce lymphoedema volume, their effects were not well established, and therefore, we could not recommend the addition of MLD to complete decongestive therapy (CDT) or compression therapy for patients with BCRL. Thus, MLD treatment appeared to be an ambiguous but potentially effective BCRL treatment. Rigorously designed high-quality randomized controlled trials with larger sample sizes are needed to further verify the effectiveness of MLD therapy in BCRL treatment.

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.

Manual Lymphatic Drainage for Breast Cancer-related Lymphedema: A Systematic Review and Meta-analysis of Randomized Controlled Trials

BackgroundThe purpose of this systematic review was to meta-analyze the effectiveness of manual lymphatic drainage (MLD) in breast cancer-related lymphedema (BCRL) patients. MethodsThe following databases: the Cochrane Library, the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Web of Science, ClinicalTrials.gov were systematically searched. All English publications before April 2021 have been retrieved without any restrictions of countries, time, or article type. We included randomized controlled trials (RCTs) examining the effectiveness of MLD versus control group without MLD of women with BCRL. The outcomes were (1) the incidence of lymphedema, (2) volumetric changes of lymphedema, (3) pain, (4) quality of life. Review Manager 5.3 was used to perform statistical analysis. ResultsIn total, 11 RCTs involving 1564 patients were included, in which 10 trials were deemed viable for inclusion in the meta-analysis. Due to the effects of MLD for BCRL, statistically significant improvements were found on the incidence of lymphedema (RR = 0.58, 95% CI [0.37, 0.93], P =.02) and pain intensity (SMD = -0.72, 95% CI [-1.34, -0.09], P = .02). Besides, the meta-analysis carried out implied that the effects that MLD had on volumetric changes of lymphedema and quality of life, were not statistically significant. ConclusionThe current evidence based on the RCTs shows that pain of BCRL patients undergoing MLD is significantly improved, while our findings do not support the use of MLD in improving volumetric of lymphedema and quality of life. Note that the effect of MLD for preventing BCRL is worthy of discussion.

Efetividade da drenagem linfática manual associada a bandagem funcional na melhora clínica do fibro edema gelóide em gestantes: ensaio clínico, controlado e randomizado

Efetividade da drenagem linfática manual associada a bandagem funcional na melhora clínica do fibro edema gelóide em gestantes: ensaio clínico, controlado e randomizado

Efetividade da drenagem linfática manual com ou sem uso da bandagem funcional na dor, fadiga e edema dos membros inferiores em gestantes: ensaio clínico, controlado e randomizado

Efetividade da drenagem linfática manual com ou sem uso da bandagem funcional na dor, fadiga e edema dos membros inferiores em gestantes: ensaio clínico, controlado e randomizado

Effectiveness of manual lymphatic drainage vs. perineal massage in secundigravida women with gestational oedema: A randomised clinical trial.

Perineal trauma (PT) may be considered as a very common injury during the childbirth. The incidence of PT was estimated in 30% to 85%, with 60% to 70% requiring suture. The present study was a prospective, single-blinded, randomised, clinical trial carried out from January 2015 to January 2016. For this study, 49 secundigravida women diagnosed with gestational oedema were recruited and randomly divided into two groups (A and B). Group A (n = 30) received the conventional treatment plus perineal massage and group B (n = 19) the conventional treatment plus manual lymphatic drainage (MLD). Visual analogue scale (VAS) and King Health's Questionnaire (KHQ) were performed to assess pain intensity and quality of life-related with urinary incontinence (UI). Pain intensity measurements showed statistically significant differences for a decrease after 30-weeks (P = .037), after 36-weeks (P = .000), and at the end of puerperium (P = .014) for MLD with respect to perineal massage group. Moreover, inter-groups repeated measures ANOVA for the values related statistically significant differences to the interaction of each applied treatment (perineal massage and MLD group, separately) over the pain intensity variable. MLD treatment reduced pain intensity with respect to perineal massage in secundigravida women with gestational oedema from 25-weeks of gestation to the end of puerperium.

The Effectiveness of Manual Lymphatic Drainage in Patients With Orthopedic Injuries.

Managing edema after trauma or injury is a primary concern for health care professionals, as it is theorized that delaying the removal of edema will increase secondary injury and result in a longer recovery period. The inflammatory process generates a series of events, starting with bleeding and ultimately leading to fluid accumulation in intercellular spaces and the formation of edema. Once edema is formed, the lymphatic system plays a tremendous role in removing excess interstitial fluid and returning the fluid to the circulatory system. Therefore, rehabilitation specialists ought to use therapies that enhance the uptake of edema via the lymphatic system to manage edema; however, the modalities commonly used are ice, compression, and elevation. Modalities such as these may be effective at preventing swelling but present limited evidence to suggest that the function of the lymphatic system is enhanced. Manual lymphatic drainage (MLD) is a manual therapy technique that assists the lymphatic system function by promoting variations in interstitial pressures by applying light pressure using different hand movements. Does MLD improve patient- and disease-oriented outcomes for patients with orthopedic injuries?

Study Regarding the Effectiveness of Manual Lymphatic Drainage in the Case of Patients with Breast Cancer that Present Lymphedema

Abstract Lymphedema is defined as a persistent increase of tissue volume caused by the blocked or absent lymphatic drainage. The purpose of this study is to analyse the effectiveness of lymphatic drainage in the treatment of lymphedema after a mastectomy, with the aim of reducing the volume of the lymphedema and improving overall symptomatology, as well as providing information regarding the impact of this treatment on quality-of-life and the physical limitations of these patients. With these objectives in mind, a series of articles evaluating the effectiveness of manual lymphatic drainage in the case of patients with breast cancer and lymphedema have been studied. The parameters under observation were: duration of lymphedema reduction and improved symptomatology (pain, a feeling of swelling of the upper limb, functional limitation, and patient dissatisfaction towards their body image). Following this analysis, one can conclude that the association of manual lymphatic drainage to physical exercise and physiotherapy has produced changes in the volume of the limb affected by the lymphedema; however, its isolated use has not resulted in significant changes

Manual lymphatic drainage therapy in patients with breast cancer related lymphoedema

BackgroundLymphoedema is a common and troublesome condition that develops following breast cancer treatment. The aim of this study is to analyze the effectiveness of Manual Lymphatic Drainage in the treatment of postmastectomy lymphoedema in order to reduce the volume of lymphoedema and evaluate the improvement of the concomitant symptomatology.MethodsA randomized, controlled clinical trial in 58 women with post-mastectomy lymphoedema. The control group includes 29 patients with standard treatment (skin care, exercise and compression measures, bandages for one month and, subsequently, compression garnments). The experimental group includes 29 patients with standard treatment plus Manual Lymphatic Drainage. The therapy will be administered daily for four weeks and the patient's condition will be assessed one, three and six months after treatment.The primary outcome parameter is volume reduction of the affected arm after treatment, expressed as a percentage. Secondary outcome parameters include: duration of lymphoedema reduction and improvement of the concomitant symptomatology (degree of pain, sensation of swelling and functional limitation in the affected extremity, subjective feeling of being physically less atractive and less feminine, difficulty looking at oneself naked and dissatisfaction with the corporal image).DiscussionThe results of this study will provide information on the effectiveness of Manual Lymphatic Drainage and its impact on the quality of life and physical limitations of these patients.Trial registrationClinicalTrials (NCT): NCT01152099

Reproducibility of sonographic soft-tissue measurement of the head and neck.

Effectiveness of manual lymphatic drainage in the head and neck region is not supported by evidence-based data. The objective of this study was to verify if the chosen locations enable the measurement of reproducible skin-to-bone distances without marking the measurement place, providing, therefore, adequate sites for long-term follow-up of the soft tissue width. Sonographic measurement was performed in 21 healthy volunteers by the same examiner on three consecutive days. Skin-to-bone distance was measured each time at five defined locations over the mandible and hyoid. The average deviation caused by consecutive measurements was estimated to be between 0.7 and 1.2 mm for the different locations. When comparing right-to-left average skin-to-bone distances, differences of a maximum of 1 mm were measured. Sonographic soft tissue width, as measured by the skin-to-bone distance at defined sites of the head and neck, is highly reproducible in healthy adults without marking these measurement sites. These regions can, therefore, be used to quantify the effectiveness of manual lymphatic drainage for head and neck lymphedema by monitoring the course of the skin-to-bone distance.