Barbieux, R., Roman, M. M., Doyenard, S., Rivière, F., Curnier, A., De Putte Van, L., Y Penafuerte Rodriguez, D., Windels, A., Saragoni, F., Leduc, O., Leduc, A., Provyn, S., & Bourgeois, P. (2019). Lymphoscintigraphic evaluation of the effects of manual lymphatic drainage at the root of the limb for patients with(upper or lower) limb lymphedema. The European Journal of Lymphology and Related Problems, 30(79), 25.

@article{16884aaa71fa4c7f8defe4a065cd5047,
title = "Lymphoscintigraphic evaluation of the effects of manual lymphatic drainage at the root of the limb for patients with(upper or lower) limb lymphedema",
abstract = "Introduction: Manual lymphatic drainage (MLD) aims to stimulate lymphatics and to decrease the edema. Although it is an important part of the complex decongestive therapy for lymphedema management, its efficiency is in doubt. The purpose of this study is to lymphoscintigraphically assess the effect of skin mobilization, non-specific massage and MLD on the root of the lower limb for patients with lower limb lymphedema. Material and Methods: 80 lymphoscintigraphical exams of the lower limb root of patients with primary and secondary lower limb lymphedema were analyzed. Lymphoscintigraphical exam consisted in imaging performed after the intradermal injections of 99mTc labeled nanosized colloids of Human Serum Albumin at the root of the limb, 1) directly after the injection (phase 1), 2) after pinching and stretching of the injection site (phase 2), 3) after a non-specific massage applied on the injection site (phase 3) and 4) after manual lymphatic drainage of the injection site (phase 4). The openings of lymphatic pathways was evaluated after each sub phase. Results: No lymphatic drainage after the injection and no improvement after the 3 interventions following the injection were observed in 5% of the cases (n=4). On the other hand, all lymphatic pathways were observed after phase 1 and 2 AND were not modified by phase 3 (nonspecific massage) and/or phase 4 (MLD) in 8.8% of the cases (n=7). For its part, nonspecific massage improved the situation in 57 cases (71.5% of the whole series) when compared to the situation observed at the end of phase 2. However, MLD improved the visualization of the lymphatic pathways in 48 cases (60%) when compared to phase 3 and was necessary to lead to the visualization of the lymphatic drainage at the level of the root of the edematous limb in 6 cases (7.5%). Conclusions: Physical therapy leads to a greater number of lymphatic collaterals openings in a region where no other technique of complex decongestive therapy technique can be applied. Introduction: Manual lymphatic drainage (MLD) aims to stimulate lymphatics and to decrease the edema. Although it is an important part of the complex decongestive therapy for lymphedema management, its efficiency is in doubt. The purpose of this study is to lymphoscintigraphically assess the effect of skin mobilization, non-specific massage and MLD on the root of the upper limb for patients with upper limb lymphedema. Material and Methods: 91 lymphoscintigraphical exams of the upper limb root of patients with secondary upper limb lymphedema were analyzed. Lymphoscintigraphical exam consisted in imaging performed after the intradermal injections of 99mTc labeled nanosized colloids of Human Serum Albumin at the root of the limb, 1) directly after the injection (phase 1), 2) after pinching and stretching of the injection site (phase 2), 3) after a non-specific massage applied on the injection site (phase 3) and 4) after manual lymphatic drainage of the injection site (phase 4). The openings of lymphatic pathways was evaluated after each sub phase. Results: No lymphatic drainage after the injection and no improvement after the 3 interventions following the injection were observed in 11% of the cases (n=10). On the other hand, all lymphatic pathways were observed after phase 1 and 2 AND were not modified by phase 3 (nonspecific massage) and/or phase 4 (MLD) in 8.8% of the cases (n=8). For its part, nonspecific massage improved the situation in 9 cases (9.9% of the whole series) when compared to the situation observed at the end of phase 2. However, MLD improved the visualization of the lymphatic pathways in 64 cases (70.3%) when compared to phase 3 and was necessary to lead to the visualization of the lymphatic drainage at the level of the root of the edematous limb in 15 cases (16.4%). Conclusions: Physical therapy leads to a greater number of lymphatic collaterals openings in a region where no other technique of complex decongestive therapy technique can be applied.",
keywords = "human serum albumin, adult, colloid, conference abstract, controlled study, female, human, human tissue, injection site, intradermal drug administration, lower limb, lymphatic system, lymphedema, major clinical study, male, manual lymphatic drainage, physiotherapy, skin, upper limb",
author = "R. Barbieux and M.M. Roman and S. Doyenard and F. Rivi{\`e}re and A. Curnier and {De Putte Van}, L. and {Y Penafuerte Rodriguez}, D. and A. Windels and F. Saragoni and O. Leduc and A. Leduc and S. Provyn and P. Bourgeois",
year = "2019",
month = feb,
day = "3",
language = "English",
volume = "30",
pages = "25",
journal = "The European Journal of Lymphology and Related Problems",
issn = "0778-5569",
publisher = "European Group of Lymphology",
number = "79",
}