1/9. Physiotherapy results in a baby with congenital lymphedema: a follow-up study.Physiotherapy results of a 6.5-month-old baby with congenital lymphedema in the lower limbs are presented in this study. Her motor developmental level and reflexes were evaluated and test results did not show any abnormal findings. Assessment of limb volume included circumferential and volumetric measurements, and photographs showing the changes in macroscopic view are presented. The physiotherapy program consisted of manual lymphatic massage, remedial exercises, multilayered inelastic compression bandaging, meticulous skin care and education of parents. The treatment lasted for 2.5 months, five days per week. Evaluations were done immediately after treatment and six months after treatment. The evaluations showed reduction in swelling after the treatment and this reduction continued during the follow-up period. It can be concluded that this physiotherapy program reduces the swelling in a baby with congenital lymphedema. Further studies are required in order to see the effectiveness of this therapy program in a greater number of subjects.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
2/9. Intraarterial lymphocyte-injection therapy for lymphedema of the leg: an examination using indium-111 oxine labeled autologous lymphocytes.A 58-year-old female patient with lymphedema of the left leg was treated by repeated intraarterial lymphocyte-injection therapy. To elucidate whether the injected lymphocytes act at the affected site of the leg, we examined the distribution of the In-111 oxine labeled lymphocytes injected into the proximal artery to the affected leg in comparison with the distribution in the other, healthy, leg. The radioactivity of the affected leg was almost two times higher than that of the healthy leg during the first 30 min after injection, and it remained higher even after 24 hours. The circumference of the affected leg of the patient decreased steadily during her hospital stay. These results, together with the clinical findings, suggest that some of the intraarterially-injected lymphocytes remained in the affected leg at least 24 hours and might play some role in reducing the volume of lymphedematous fluid.- - - - - - - - - - ranking = 0.5keywords = volume (Clic here for more details about this article) |
3/9. Secondary lymphoedema of the lower leg as an unusual side-effect of a liquid silicone injection in the hips and buttocks.We report an unusual case of secondary lymphoedema of the lower extremities as a result of injections of liquid silicone. A 30-year-old transsexual had received large-volume injections of silicone in the hips and buttocks for cosmetic purposes in order to obtain a female body form. Painful silicone granulomas developed in both the treated areas and areas outside the original injection location, and a progressive lymphoedema of feet and legs developed during a period of 5 years.- - - - - - - - - - ranking = 0.5keywords = volume (Clic here for more details about this article) |
4/9. Physiotherapy management of patients with hiv-associated Kaposi's sarcoma.BACKGROUND: Kaposi's sarcoma is the most common form of cancer in patients with human immunodeficiency virus (hiv) infection. Although Kaposi sarcoma lesions may contribute to significant physical impairments, there is a lack of scientific literature detailing the role of physiotherapy in the treatment of hiv-associated Kaposi's sarcoma. The present Case Report includes two males, aged 36 and 39 years, seropositive for hiv with invasive Kaposi's sarcoma. METHOD AND RESULTS: Patient A was evaluated for bilateral foot pain caused by plantar surface Kaposi s sarcoma lesions that rendered him unable to walk. He progressed to walking 400feet after a treatment regimen of gait training with the use of custom plastazote sandals. Patient B was evaluated for right lower extremity lymphoedema secondary to invasive Kaposi's sarcoma. He experienced an 18% reduction in limb volume, a 38% reduction in pain and a 20 degrees increase in terminal knee flexion after therapeutic exercise and the use of compressive bandaging and garments. CONCLUSIONS: This Case Report suggests that physiotherapy interventions may be valuable in the conservative management of patients with hiv-associated Kaposi s sarcoma.- - - - - - - - - - ranking = 0.5keywords = volume (Clic here for more details about this article) |
5/9. The use of suction curettage as adjunct to the management of lymphedema.This case report describes the use of suction curettage as an adjunct to the method of skin and subcutaneous tissue excision in the treatment of primary lymphedema. Pretreatment with high-vacuum cannula suction can provide three advantages over straightforward primary excision and closure; (1) larger volumes of skin and subcutaneous tissue can be resected at a single setting; (2) tensionless closure can be obtained without skin flap undermining; and (3) procedural blood loss is minimized.- - - - - - - - - - ranking = 0.5keywords = volume (Clic here for more details about this article) |
6/9. Clinical experiences using pneumatic massage therapy for edematous limbs over the last 10 years.A pneumatic massage apparatus has been developed for the treatment of peripheral lymphedema. The stagnant lymph and venous blood are displaced toward the heart by this pneumatic massage. It has been applied to more than 650 patients with edematous limbs in the authors' Hadomer clinic over the last ten years. Satisfactory results were obtained, including decrease in swelling, pain, and induration. The authors' clinical experiences and statistical analysis of the patients are reported here. Statistical analysis: 9 primary (4 males and 5 females) and 646 secondary (28 males and 618 females) patients with lymphatic edema of extremities have been treated. The majority of the patients had postmastectomy edema of the upper extremity. Clinical studies: The circumference of the edematous limb was measured before and after pneumatic massage treatment of forty to sixty minutes, daily or every second day. (Formula: see text). The rate of swelling was calculated by the formula described above. Twenty-six cases, treated with pneumatic massage for more than fifteen months, have been investigated. A decrease in the rate of swelling was observed in 14 cases (54%), there was no change in 7 (27%), and an increase was seen in 5 (19%). electric impedance plethysmographic analysis of peripheral lymph volume and blood flow indicated that pneumatic massage was effective in the treatment of edema of the limbs, and its effectiveness was confirmed also by core temperature measurement of the hand during pneumatic massage. The decreased circumference of the edematous limb was kept constant for a long period of time by daily repeated pneumatic massage and ordinary conservative treatments. In conclusion, most lymphedema is of a secondary type. Pneumatic massage was effective in the treatment of peripheral lymph edema, and the improvement was maintained by repeated daily pneumatic massage and ordinary conservative treatment. Therefore, before it becomes worse, lymphedema of the limb should be treated by use of conservative treatments, including pneumatic massage continued as a long-term schedule.- - - - - - - - - - ranking = 0.5keywords = volume (Clic here for more details about this article) |
7/9. Microlymphaticovenous anastomosis in the treatment of lower limb obstructive lymphedema: analysis of 91 cases.Since 1980, 110 cases of lymphedema have been treated by microlymphaticovenous anastomosis. Of these 110 patients, 91 with obstructive lymphedema of lower limbs were reviewed. The immediate and long-term results have been very satisfactory. Excellent and good results were obtained in 79.1 percent. An average reduction in circumference of the affected limb of 6.4 cm and an average reduction of excess volume of 59.2 /- 29.5 percent (representing 703 /- 850 ml) were obtained. Subjective symptoms and objective signs were improved. Four patients (4.4 percent) showed poor results owing to severe fibrosis of neighboring tissue; no lymphatics could be located for anastomosis. As the authors gained experience with the operation over the last 3 years, they modified the operative procedure, the anastomotic technique, and the selection of collective lymphatics. The data obtained suggest that the quality of results is proportional to the number of anastomoses. In order to obtain the best results, the criteria for selection of patients and avoidance of postoperative relapse are discussed. Finally, a test for determination of the indications for microlymphatic surgery is described.- - - - - - - - - - ranking = 0.5keywords = volume (Clic here for more details about this article) |
8/9. Effects of continuous passive motion on the edematous hands of two persons with flaccid hemiplegia.OBJECTIVES. This study evaluated the effect of the use of a continuous passive motion device for the edematous hands of two persons with flaccid hemiplegia. METHOD. The subjects were both 1 month post-cerebrovascular accident with left-sided hemiplegia. Each subject's routine therapy program was maintained throughout this ABA design study. During the first week, baseline data were gathered, during the second week the intervention was provided (2 hr of continuous passive motion device use), and during the third week data were gathered with treatment withdrawn. Edema was measured with a hand volumeter and finger circumference. RESULTS. The continuous passive motion device had an effect in reducing edema in the hands of the two subjects. CONCLUSION. The continuous passive motion device is a readily available tool that could enhance the treatment of edematous hands of persons with flaccid hemiplegia by offering a contribution to already established treatment protocols. Further research is needed, however, to establish guidelines for use.- - - - - - - - - - ranking = 0.5keywords = volume (Clic here for more details about this article) |
9/9. Persistence of lymphedema reduction after noninvasive complex lymphedema therapy.We treated 119 consecutive patients with lymphedema with complex lymphedema therapy (CLT). lymphedema reductions after CLT averaged 62.6% in the 56 patients with one affected arm and 68.6% in the 38 patients with one affected leg. In the 23 patients with bilateral affected lower limbs, lymphedema volume decreased by 3,681 cm3 in the right leg and by 3,433 cm3 in the left leg. Due to its small number, the group with bilateral affected arms was not analyzed. After 36 months' follow-up, the average reduction increased to 63.8% in individuals with one affected arm and remained at 62.7% in those with one affected leg. For statistical analysis, the amount of reduction after CLT in the group with bilateral affected legs was considered to be 100%. During follow-up, the right leg was maintained at 99.59% of the initial reduction and the left leg improved to 120%. patients who were compliant showed significant increases in lymphedema reduction, whereas noncompliant patients lost part of their initial reduction.- - - - - - - - - - ranking = 0.5keywords = volume (Clic here for more details about this article) |