Extremity Circumference Research Articles

Physical therapy in a patient with viral -encephalitis hemi-paresis: A Case report

The purpose of the rehabilitation program is to improve motor skills, coordination, sensory system, mobilization and other existing disorders to achieve activity of daily living (ADL). Physical therapy as part of the multidisciplinary approach can provide core stability exercises, muscular facilitation and stimulation of motion of the upper and lower extremities, balance exercises and mobility exercises, as well as strengthening exercises with PNF facilitation and active stimulation techniques and using the patient's body weight as a training burden. Bobath approach and facilitation exercise can reduce spasticity by strengthening the antagonist muscles. MMT right upper extremity 3/5, left upper extremity 4/5, right lower extremity 2/5, and left lower extremity 3/5. Ashworth scale right upper extremity 1/4, right lower extremity 2/4, and left lower extremity 1/4. Clonus is reduced, the patient can stand with maximum support without clonus for 10 minutes. Trunk impairment scale 12/23 and Barthel index 65/100. Anthropometric examination showed differences in the circumference of the lower extremities, namely the right patella circumference 34-32 cm left, right upper leg 39 cm-left 37 cm, and left lower leg 29-24 cm. Mobilize the patient to a laying position with minimal assistance. Mobilization of the patient is being able to sit with minimal assistance, namely stabilization in the pelvis, sitting to standing with moderate support, which is supported at the knee bilaterally, and standing with support at the knee and pelvic for 10 minutes. This case report concludes that although physiotherapy is done late with strengthening exercise and core stability strengthening techniques, lying down strengthening exercise, it can improve motor skills, coordination, which in turn will increase the patient's independence in carrying out functional activities and ADLs.

The effect of aroma lymphatic tressage on taxane-induced lower-extremity edema in breast cancer patients.

Taxanes are effective chemotherapy drugs for breast cancer care, but adverse effects pose a significant challenge in cancer treatment. Taxane-induced fluid retention and lower-extremity edema are two of the important dose-limiting toxicity and result in decreased quality of life (QoL). However, there is no standard of care to alleviate the symptoms. We conducted a clinical study to assess the efficacy of short-term aroma lymphatic tressage therapy (ALTT) in reducing taxane-induced edema in breast cancer patients. In this phase 2 clinical trial, patients with edema of CTCAE grade 2 or higher were enrolled and conducted 8 sessions of ALTT. The primary endpoint was to determine the proportion of patients with a reduction in lower extremity circumference of 3% or more before and 6weeks after starting ALTT. The change in QoL was assessed as the secondary endpoint using QoL questionnaires. A total of 37 breast cancer patients completed the protocol and were analyzed. The median sum of the 3-point circumference (thigh, calf, and ankle) was 230.8cm (IQR 218-243) in the baseline and 220.2cm (IQR 212-236) at the end of the study. The average decrease of circumference was 3.8%. About, 23 patients (62%) experienced a circumference decrease of 3% or more. An improvement in every scale of FACT-TAXANE and EORTC-QLQ-C30 was observed when comparing questionnaire results before and at the end of the intervention (P<0.0001). Eight sessions of ALTT over 4weeks were effective in reducing lower-extremity edema and resulted in improvement of QoL in patients with breast cancer.

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.

Prophylactic complex physiotherapy in gynecologic cancer survivors: patient-reported outcomes based on a lymphedema questionnaire

ObjectiveLower extremity lymphedema secondary to cancer treatment impacts quality of life for gynecological cancer survivors. Complex decongestive physiotherapy is applied when lymphedema is diagnosed, but prophylactic physiotherapy is not yet...

Effect of Physical Therapy on Circumference Measurement and Extremity Volume in Patients Suffering from Lipedema with Secondary Lymphedema.

Background: Lipedema is a chronic and progressive disease. Many complications can occur if the disease is not treated. The most important of these complications is lipedema with secondary lymphedema. There are very few publications about lipedema with secondary lymphedema. The aim of this study is to investigate the effect of physical therapy on lower extremity circumference and volume in patients suffering from lipedema with secondary lymphedema. Methods and Results: All patients received pneumatic compression and complex decongestive therapy (CDT). Perometer measurement was made at five distinct points. Fifteen patients were included in the study. It was seen that significant reduction was found in the circumference of three of the five points of measurements performed in the left leg, whereas significant reduction was found in the circumference of four of the five points of measurements performed in the right leg. Also, there was a decrease in the extremity volume in both legs. Conclusion: Combined application of CDT and pneumatic compression in patients suffering from lipedema with secondary lymphedema is an effective treatment method in reducing lower extremity volume and circumference measurement.

Effectiveness of neuromuscular electrical stimulation in severe acute pancreatitis complicated patients with acute respiratory distress syndrome: study protocol for a randomized controlled trial

BackgroundSevere acute pancreatitis complicated by acute respiratory distress is a common cause of intensive care unit (ICU) admission. These patients are at risk of a decline in physical activity due to bed rest. Neuromuscular electrical stimulation (NMES) has been recommended for ICU patients to strengthen muscles, but its effects on muscle atrophy, respiratory function, multiple organ dysfunction, and functional status of these patients remain to be proven.MethodsPatients (n = 80) will be prospectively randomized into an NMES group and a control group. The NMES group will receive NMES for 1 h per day for 7 days, and both the control and NMES groups will receive usual care. The efficacy will be assessed by an experienced physiotherapist and sonographer who will be blinded to the patient’s group assignment. Muscle power assessment (MRC scale), lower extremity circumference, grip strength, activities of daily living (Barthel index), and Marshall scores will be measured at baseline and posttreatment. The functions of the diaphragm assessments will be measured daily. Barthel index measurements will be followed up in the 1st month, 3rd month, and 6th month after discharge.DiscussionThe trial will explore the effectiveness of NMES in functional status and diaphragm function in patients with SAP complicated with ARDS. The results of this trial will provide strong evidence of the efficacy of NMES in treating SAP patients with ARDS.Trial registrationThis trial has been registered at the Chinese Clinical Trial Registry, and the registry name is “Effectiveness of neuromuscular electrical stimulation in severe acute pancreatitis complicated patients with acute respiratory distress syndrome: study protocol for a randomized controlled trial,” URL: https://www.chictr.org.cn, numbered ChiCTR2300068995. Date of Registration: 2023-03-03.

The association of central and extremity circumference with all-cause mortality and cardiovascular mortality: a cohort study.

Central obesity increases the risk of several diseases, including diabetes, cardiovascular disease (CVD), and cancer. However, the association between extremity obesity and mortality has not been extensively evaluated. The objective of this study was to investigate the quantitative effects of waist circumference (WC), arm circumference (AC), calf circumference (CC), and thigh circumference (TC) on all-cause mortality and CVD mortality. The study used data from the National Health and Nutrition Examination Survey (NHANES) sample survey from 1999 to 2006. A total of 19,735 participants were included in the study. We divided the participants into four groups (Q1-Q4) and used Q1 as a reference to compare the risk of all-cause mortality and CVD mortality in Q2-Q4. COX proportional hazard regression model was used to analyze the relationship between WC, AC, CC and TC on all-cause and CVD mortality. In addition, we conducted a stratified analysis of gender. After a mean follow-up of 11.8 years, we observed a total of 3,446 deaths, of which 591 were due to cardiovascular disease. The results showed that for both men and women, compared to the first group, the risk of all-cause mortality was significantly higher in the other three groups of WC and significantly lower in the other three groups of AC, CC, and TC. Similar results were observed after adjusting for confounding factors such as demographics. Our results show that all-cause and CVD mortality are positively associated with measures of central obesity and negatively associated with measures of extremity obesity, and that AC, CC, and TC can be used as potential tools to measure prognosis in the general population.

Conservative treatment versus lymphaticovenular anastomosis for early-stage lower extremity lymphedema

ObjectiveSeveral options for the treatment of lower extremity lymphedema (LEL) can be broadly classified into conservative treatment, such as compression garments and decongestive lymphatic therapy, and surgical treatment, such as lymphaticovenular anastomosis (LVA). The purpose of our study was to clarify the superiority of these treatments by comparing the outcomes of LVA with those of conservative treatment for early-stage LEL. MethodsWe performed a single-center, retrospective cohort study. The patients with LEL who presented to our department between January 2015 and December 2022 were identified and classified into two groups: conservative treatment and surgical treatment. The LEL indexes, calculated from the four lower extremity circumferences and the body mass index, were compared at the 6-, 12-, and 24-month follow-up between the two groups. ResultsOf the 101 patients with LEL, 53 with 72 affected limbs (conservative treatment, 39 patients and 53 affected limbs; surgical treatment, 15 patients and 19 affected limbs) were included in the present analysis. The therapeutic effect for reducing edema, as determined by comparing the corrected LEL index at 12 months (103.7 ± 12.7 vs 91.9 ± 10.7; P = .005) and 24 months (103.1 ± 12.9 vs 83.8 ± 7.2; P < .001), was significantly higher in the surgical treatment group than that in the conservative treatment group. The conservative treatment group showed little change in the corrected LEL index at ≤24 months of follow-up (+3.1%; P = .299). In contrast, the surgical treatment group showed a significant reduction in edema at 24 months according to the corrected LEL index (−16.2%; P = .019). ConclusionsIn early-stage LEL, conservative treatment centered on compression therapy alone only maintained edema (ie, edema did not worsen or improve). In contrast, LVA with compression therapy reduced edema.

The effect of kinesio taping on edema, pain, and functionality after total knee arthroplasty: A randomised sham-controlled double blinded clinical study

BackgroundThere are current studies on kinesio taping (KT) application after total knee arthroplasty (TKA), but there is no definite consensus on its effectiveness and application method yet. This study aims to evaluates the effectiveness of KT applied added to the conservative postoperative physiotherapy program (CPPP) after TKA on postoperative edema, pain, range of motion, and functions on the early period. Materials and methodsThis prospective, randomized, controlled, double-blind study was conducted in with 187 patients undergoing TKA. The patients were divided into 3 groups as kinesio taping (KTG), sham taping (STG) and control group (CG). KT lymphedema technique and epidermis, dermis, fascia technique were applied on the 1st and 3rd days postoperatively. Extremity circumference and joint range of motion (ROM) were measured. Visual Analog Scale, Oxford Knee Scale filled. All patients were evaluated preoperatively, on the 1st day, 3rd day, and 10th day postoperatively. ResultsThere were 62 patients in CTG, 62 patients in STG, and 63 patients in CG. In all circumference measurements, the difference between post-op10th day (PO10D) diameter and preoperative diameter measurement was less in KTG than in CG and STG (p < 0.001). CG was higher than the STG in the ROM values measured at PO10D.There was no significant difference between the groups in terms of OKS values (P:0.648). CG was higher than STG in post-op 1st day VAS values (P:0.042). ConclusionAdding KT to CPP after TKA reduces edema in the acute phase, but has no additive effect on pain, functionality, and ROM.

A clinical study of liposuction followed by lymphovenous anastomosis for treatment of breast cancer-related lymphedema.

In this work, we studied the clinical effect of liposuction followed by lymphovenous anastomosis (LVAs) for the treatment of breast cancer-related lymphedema (BCRL). We analyzed 158 patients with unilateral upper limb BCRL who underwent liposuction followed by LVAs 2-4 months later. Arm circumferences before and 7 days after the combined treatments were prospectively recorded. Circumferences of different upper extremities were measured before the procedure, 7 days after LVAs, and during the follow-ups. Volumes were calculated with the frustum method. During the follow-ups, the conditions of patients' treated arms, i.e., the frequency of erysipelas episodes and dependence on compression garments, were recorded. The mean circumference difference between two upper limbs decreased significantly from M (P25, P75) of 5.3 (4.1, 6.9) preoperatively to 0.5 (-0.8, 1.0) (P < 0.05) 7 days after treatments, while at follow-up 0.3 (-0.4, 1.0). The mean volume difference decreased significantly from M (P25, P75) of 838.3 (662.4, 1,129.0) preoperatively to 7.8 (-120.3, 151.4) (P < 0.05) 7 days after treatments, while at follow-up 43.7 (-59.4, 161.1). The incidence of erysipelas also significantly decreased (P < 0.05). 6.3% of patients were already independent of compression garments during the past six months or even more. Liposuction followed by LVAs is an effective method for the treatment of BCRL.

Fluid Distribution Patterns in Early-Stage Upper Extremity Lymphedema.

Magnetic resonance imaging (MRI) stage 1 (early stage) upper extremity lymphedema is characterized by fluid infiltration in the subcutaneous tissues that does not exceed 50% of the extremity circumference at any level. The spatial fluid distribution in these cases has not been detailed and may be important to help determine the presence and location of compensatory lymphatic channels. The aim of this study is to determine whether there was a pattern of distribution of fluid infiltration in patients with early-stage lymphedema that could correspond to known lymphatic pathways in the upper extremity. A retrospective review identified all patients with MRI stage 1 upper extremity lymphedema who were evaluated at a single lymphatic center. Using a standardized scoring system, a radiologist graded the severity of fluid infiltration at 18 anatomical locations. A cumulative spatial histogram was then created to map out regions where fluid accumulation occurred most and least frequently. Eleven patients with MRI stage 1 upper extremity lymphedema were identified between January 2017 and January 2022. The mean age was 58 years and the mean BMI was 30 m/kg2. One patient had primary lymphedema and the remaining 10 had secondary lymphedema. The forearm was affected in nine cases, and fluid infiltration was predominantly concentrated along the ulnar aspect, followed by the volar aspect, while the radial aspect was completely spared. Within the upper arm, fluid was primarily concentrated distally and posteriorly, and occasionally medially. In patients with early-stage lymphedema, fluid infiltration is concentrated along the ulnar forearm and the posterior distal upper arm, which aligns with the tricipital lymphatic pathway. There is also sparing of fluid accumulation along the radial forearm in these patients, suggesting a more robust lymphatic drainage along this region, possibly due to a connection to the lateral upper arm pathway.

Symptomatic fractured iliac venous stent in a young patient.

A 30-year-old man, avidly athletic (jogging, swimming), presented with a 2-year history of recurrent, lifestyle-limiting left lower extremity exertional fatigue. He consented to this publication. Symptoms initially resolved for 6 months after left iliofemoral vein stenting (16 × 100 mm Venovo) elsewhere for occlusion of indeterminate etiology. Physical examination revealed tightness, increased left lower extremity circumference without signs of chronic venous stasis, and normal arterial pulses. He denied history of venous thromboembolism.

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).

The effect of the combined use of complex decongestive therapy with electrotherapy modalities for the treatment of breast cancer-related lymphedema: a randomized clinical trial

BackgroundWe evaluated the effects of combined complex decongestive therapy (CDT) with electrotherapy modalities (ultrasound and faradic currents) in patients with breast cancer-related lymphedema (BCRL), investigating upper extremity circumference, volume, pain, and functional disability.MethodsThirty-nine patients with unilateral BCRL were randomly allocated to three groups (n = 13) as the following: The control group received CDT, the ultrasound group received CDT and therapeutic ultrasound, and the faradic group received CDT and faradic current. All the participants underwent treatment for 10 sessions. The outcomes including volume, circumference (measured at five points), pain intensity, and functional disability of the affected upper extremity were evaluated at baseline and after the treatment.ResultsFollowing the treatment, an improvement was noted in lymphedema volume, pain, and functional disability in all the three groups and there was a significant difference between the groups (P < 0.05). However, changes in limb circumference at the end of the treatment were not significantly different among the three groups in any sites (P > 0.05).ConclusionThe combination of electrotherapy modalities, faradic current or ultrasound, with CDT can result in a greater reduction in lymphedema volume, pain, and functional disability in patients with BCRL.Trial registrationIRCT, IRCT201310292391N14, registered 03/01/2016.

Comparison of various indices for predicting sarcopenia and its components in patients receiving peritoneal dialysis

This study aimed to evaluate and compare the usefulness of four indices—arm circumference, thigh circumference, mid-arm muscle circumference (MAMC), and thigh muscle circumference (TMC)—with that of other classical indicators of body composition in the prediction of sarcopenia and two sarcopenia-related components in patients receiving peritoneal dialysis (PD) grouped by sex. The data of all patients receiving PD who visited a tertiary medical center were collected (n = 214); of them 199 patients undergoing PD were included in the final analyses. Data on baseline characteristics and measurements, including circumferences of appendicular sites, handgrip strength (HGS), and appendicular lean mass (ALM) index, were obtained during a routine peritoneal membrane equilibration test. Body composition was evaluated using dual-energy X-ray absorptiometry. The ALM index (kg/m2) was defined as the sum of lean mass in the upper and lower extremities divided by height squared. Sarcopenia was defined as low HGS and low muscle mass based on the cut-off values in the Asian Working Group for Sarcopenia guideline. The circumferences of the lower extremities showed the greatest association with the ALM index in both sexes. Prediction of HGS was better with the MAMC than with the other indices in the male patients, whereas none of the indices were associated with HGS in the female patients. Moreover, the MAMC in the male patients and TMC in the female patients were the strongest predictors of sarcopenia among the six anthropometric indices. This study showed that the MAMC in male PD patients and TMC in female PD patients might be the best predictors of sarcopenia. However, the TMC was associated with sarcopenia regardless of HGS in the female PD patients. These findings suggest that, in PD patients, different indices should be considered in predicting sarcopenia or its components based on the sex.

근막 이완기법이 여성의 하지부종과 셀룰라이트에 미치는 영향

The purpose of this study is to verify the changes in edema and cellulite before and after 9 weeks of myofascial relaxation technique in women (average 36.2 years; 23 patients) suffering from edema of the lo wer extremities and cellulite. To this end, a research model was designed based on previous studies and e mpirical analysis was conducted through body analysis. The lower extremity edema and circumference analy sis were measured with a body composition analyzer (Inbody 970, Korea), and the cellulite stage was meas ured with a cell-meter (cell-meter., Italiy) to derive the results. The research results are as follows. First, it was found that the myofascial relaxation technique had a positive result (p<.05) on body water and extracel lular fluid in women. Second, it was found that the fascial relaxation technique had a significant effect (p<. 01) on the circumference of the lower extremities of women. Third, it was found that the myofascial relaxa tion technique had a positive effect on cellulite in women. Although the results of this study showed that t he fascia relaxation technique had a significant effect on edema, girth, and cellulite in women's lower extre mities, the limitation of the fascial relaxation technique was that it only tested the physical factors of wom en's lower extremities. In order to see the integrated effect of myofascial relaxation technique, it is hoped t hat future research will proceed with an in-depth study by adding the psychological change variables of wo men.

근막 이완기법이 여성의 하지부종과 셀룰라이트에 미치는 영향

The purpose of this study is to verify the changes in edema and cellulite before and after 9 weeks of myofascial relaxation technique in women (average 36.2 years; 23 patients) suffering from edema of the lo wer extremities and cellulite. To this end, a research model was designed based on previous studies and e mpirical analysis was conducted through body analysis. The lower extremity edema and circumference analy sis were measured with a body composition analyzer (Inbody 970, Korea), and the cellulite stage was meas ured with a cell-meter (cell-meter., Italiy) to derive the results. The research results are as follows. First, it was found that the myofascial relaxation technique had a positive result (p<.05) on body water and extracel lular fluid in women. Second, it was found that the fascial relaxation technique had a significant effect (p<. 01) on the circumference of the lower extremities of women. Third, it was found that the myofascial relaxa tion technique had a positive effect on cellulite in women. Although the results of this study showed that t he fascia relaxation technique had a significant effect on edema, girth, and cellulite in women's lower extre mities, the limitation of the fascial relaxation technique was that it only tested the physical factors of wom en's lower extremities. In order to see the integrated effect of myofascial relaxation technique, it is hoped t hat future research will proceed with an in-depth study by adding the psychological change variables of wo men.

근막 이완기법이 여성의 하지부종과 셀룰라이트에 미치는 영향

The purpose of this study is to verify the changes in edema and cellulite before and after 9 weeks of myofascial relaxation technique in women (average 36.2 years; 23 patients) suffering from edema of the lo wer extremities and cellulite. To this end, a research model was designed based on previous studies and e mpirical analysis was conducted through body analysis. The lower extremity edema and circumference analy sis were measured with a body composition analyzer (Inbody 970, Korea), and the cellulite stage was meas ured with a cell-meter (cell-meter., Italiy) to derive the results. The research results are as follows. First, it was found that the myofascial relaxation technique had a positive result (p<.05) on body water and extracel lular fluid in women. Second, it was found that the fascial relaxation technique had a significant effect (p<. 01) on the circumference of the lower extremities of women. Third, it was found that the myofascial relaxa tion technique had a positive effect on cellulite in women. Although the results of this study showed that t he fascia relaxation technique had a significant effect on edema, girth, and cellulite in women's lower extre mities, the limitation of the fascial relaxation technique was that it only tested the physical factors of wom en's lower extremities. In order to see the integrated effect of myofascial relaxation technique, it is hoped t hat future research will proceed with an in-depth study by adding the psychological change variables of wo men.

Physical Therapy Following Saucerisation of Discoid Meniscus – a Case Study

Introduction: Discoid meniscus is a structure with altered shape, which causes it to frequently undergo injuries and lesions. Pain, limping, limited range of motion of the knee joint and swelling are characteristic signs of this pathology. Therapeutic possibilities include meniscectomy and saucerisation. Research objective: The study aim was assessment of the therapeutic effectiveness in a patient after saucerisation of discoid meniscus. Material and methods: A 12-year-old female patient after saucerisation of lower left limb lateral discoid meniscus (type I) was subjected to 32-week physical therapy treatment. Testing included determining the range of knee joint flexion and extension movements, as well as measuring the circumference of the lower extremities 15 cm above the patella. The Kujala Score (Anterior Knee Pain Scale) and Ikeuchi grading system were employed during the 1st, 3rd, 8th, 21st and 32nd weeks postoperatively. Results: In the final stage of physical therapy, complete range of knee joint motion was achieved, the Kujala Scale score totalled 98 points and the thigh circumference of the operated limb increased by 4 cm. The circumferences of the lower extremities differed by 2 cm in the final phase of physical therapy. Conclusions: The employed postoperative protocol effectively influenced the functional state of the patient.

Tumescent liposuction for lipoedema: A systematic review of clinical effectiveness and safety

Abstract Background Tumescent liposuction is an established method for surgical therapy of lipoedema - a chronic, progressive, and painful fat distribution disorder. We aimed to assess the clinical effectiveness and safety of liposuction in patients with lipoedema (stage I-III) compared to any conservative treatment, concerning patient-relevant outcomes, such as reduction of pain, reduction in the size of extremities, improvement in quality of life (QoL), and safety events. Methods A systematic review was conducted, and five databases were searched. In-/exclusion criteria were predefined according to the PICOS scheme. The internal validity of the included studies was assessed using the IHE checklist; strength of evidence for safety outcomes by the GRADE approach. Results Six prospective uncontrolled trials (467 patients) were included for assessment of clinical effectiveness. Pain outcomes (patient-reported) statistically significantly improved at six-months follow-up and up to 12 years after liposuction (six studies). Reduced sizes of patients' extremities before-and-after liposuction were reported in three studies regarding reduced leg volume and circumference of lower extremities. Statistically significant improvements in lipoedema-related QoL outcomes were reported in four studies. Seventeen post-operative adverse events occurred overall (492 patients, one additional retrospective study), including five serious adverse events. Other reported procedure-related adverse events comprise, e.g., post-operative wound infections and bleedings. Studies were judged with moderate/high risk of bias. Strength of evidence for safety outcomes was judged to be very low. Conclusions The current evidence is insufficient to prove that tumescent liposuction as safe as und more effective than conservative therapy for lipoedema. However, based on the limited evidence of the included uncontrolled studies, liposuction may potentially reduce lipoedema-associated clinical symptoms and improve the QoL. Key messages Based on the limited evidence of identified uncontrolled studies, liposuction may potentially reduce lipoedema-associated clinical symptoms and improve the quality of life of affected females. High-quality comparative studies need to be awaited. The results may support and influence the effect estimates considerably.