Effective treatment of lymphedema of the extremities.

Ko DS1, Lerner R, Klose G, Cosimi AB.

Author information

Abstract

OBJECTIVE:

To define the immediate and long-term volumetric reduction following complete decongestive physiotherapy (CDP) for lymphedema.

DESIGN:

Prospective study of consecutively treated patients.

SETTING:

Freestanding outpatient referral centers.

PATIENTS:

Two hundred ninety-nine patients referred for evaluation of lymphedema of the upper (2% primary, 98% secondary) or lower (61.3% primary, 38.7% secondary) extremities were treated with CDP for an average duration of 15.7 days. Lymphedema reduction was measured following completion of treatment and at 6- and 12-month follow-up visits.

INTERVENTION:

Complete decongestive physiotherapy is a 2-phase noninvasive therapeutic regimen. The first phase consists of manual lymphatic massage, multilayered inelastic compression bandaging, remedial exercises, and meticulous skin care. Phase 2 focuses on self-care by means of daytime elastic sleeve or stocking compression, nocturnal wrapping, and continued exercises.

MAIN OUTCOME MEASURES:

Average limb volumes in milliliters were calculated prior to treatment, at the end of phase 1, and at 6- to 12-month intervals during phase 2 to assess percent volume reduction.

RESULTS:

Lymphedema reduction averaged 59.1% after upper-extremity CDP and 67.7% after lower-extremity treatment. With an average follow-up of 9 months, this improvement was maintained in compliant patients (86%) at 90% of the initial reduction for upper extremities and lower extremities. Noncompliant patients lost a part (33%) of their initial reduction. The incidence of infections decreased from 1.10 infections per patient per year to 0.65 infections per patient per year after a complete course of CDP.

CONCLUSIONS:

Complete decongestive physiotherapy is a highly effective treatment for both primary and secondary lymphedema. The initial reductions in volume achieved are maintained in the majority of the treated patients. These patients typically report a significant recovery from their previous cosmetic and functional impairments, and also from the psychosocial limitations they experienced from a physical stigma they felt was often trivialized by the medical and payor communities.

TO AVAIL LYMPHEDEMA TREATMENT CONTACT 919819559990 (MUMBAI)

PMID:

 

9565129

 

[PubMed - indexed for MEDLINE]

Foldi's Textbook of Lyphology, 2^nd Ed.
Position Statement of the National Lymphedema Network. Topic: Exercise.  http://www.lymphnotes.com/article.php/id/401/

OMG, you're texting your way to back pain (mobile causing neck and back pain)

Humans were designed to stand upright. And yet in this modern world, too many of us spend our days with our heads slumped over for a simple reason: we're staring at the tiny screen of a smartphone.
People spend an average of 2 to 4 hours each day with their neck bent at this unnatural angle while shooting off emails or texts. That's 700 to 1,400 hours a year. The success of social media is has led to an epidemic of bad smartphone posture. 

eople who have poorer posture often have poorer physical and emotional health. The researchers define bad posture as "the head in a tilted forward position and the shoulders dropping forward in a rounded position."

Bad posture has been linked to a host of medical problems, including headaches and other neurological problems, depression, constipation, and heart disease. At a minimum, constant slouching is likely to cause a lot of chronic pain.

This is why Hansraj said it's important to be mindful of your smartphone posture.
"While it is nearly impossible to avoid the technologies that cause these issues, individuals should make an effort to look at their phones with a neutral spine and to avoid spending hours each day hunched over," the authors write in their study.