THE EFFECTS OF MANUAL LYMPHATIC DRAINAGE ON LOCAL TISSUE WATER RATES AND QUALITY OF LIFE IN INDIVIDUALS DIAGNOSED WITH CHRONIC VENOUS DISEASE WITH AND WITHOUT VENOUS REFLUX: A PILOT STUDY
Yıl 2022,
Cilt: 7 Sayı: 2, 1 - 11, 17.08.2022
Elif Sakızlı Erdal
,
Abdullah Ozer
,
Emetullah Cindil
,
İlke Keser
Öz
Background: Manual Lymphatic Drainage (MLD) is an alternative treatment approach that can be used in patients with a diagnosis of Chronic Venous Insufficiency (CVI). This study aimed to examine the effects of MLD on local tissue water and quality of life (QoL) in CVI patients. Methods: Ten patients were included in the study. The patients with venous reflux greater than 0.5 seconds enrolled in the CVI group, and individuals without venous reflux were categorized as the Chronic Venous Disease (CVD) group. The water percentages in the local tissue were measured with the MoistureMeterD Compact device. QoL was assessed with the Venous Insufficiency Epidemiologic and Economic Study Quality-of-Life Questionnaire (VEINES-QOL/Sym). Results: Symptom score increased from 32.60±5.68 to 36.40±6.95, and total QoL score increased from 51.8±5.89 to 55.6±5.32 significantly in patients with CVD. Symptom score increased from 29.00±5.96 to 34.00±6.12, and total QoL score increased from 47.20±8.58 to 52.00±5.96 significantly in patients with CVI. No more significant improvement in quality of life in either CVI or CVD group (p>0.05). MLD has an effect on the water absorption from the local tissue in the CVD although this decrease was not statistically significant, and it was insufficient in the CVI stage (p>0.05). Conclusion: It was thought that MLD could provide relief in the symptoms and an improvement in QoL, independent of the presence of venous reflux. In future studies, the change in the local tissue water with MLD should be examined in patients with CVI with a larger number of patients.
Teşekkür
Elif Sakizli Erdal was a TUBITAK PhD scholar during her doctoral education. This study is part of a doctoral thesis. We would like to thank TUBITAK for its contributions.
Kaynakça
- 1. Wittens C, Davies A, Bækgaard N, Broholm R, Cavezzi A, Chastanet S, et al. Editor's choice–management of chronic venous disease: clinical practice guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2015; 49(6):678-737.
- 2. Pocock ES, Alsaigh T, Mazor R, Schmid-Schönbein GW. Cellular and molecular basis of venous insufficiency. Vasc Cell. 2014; 6(1):1-8.
- 3. Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2005; 111(18):2398-409.
- 4. Mortimer PS. Implications of the lymphatic system in CVI-associated edema. Angiology. 2000; 51(1):3-7.
- 5. Raju S, Furrh IV JB, Neglén P. Diagnosis and treatment of venous lymphedema. J Vasc Surg. 2012; 55(1):141-9.
- 6. Morris RJ, Woodcock JP. Evidence-based compression: prevention of stasis and deep vein thrombosis. Ann Surg. 2004; 239(2):162.
- 7. Duque MI, Yosipovitch G, Chan YH, Smith R, Levy P. Itch, pain, and burning sensation are common symptoms in mild to moderate chronic venous insufficiency with an impact on quality of life. J Am Acad Dermatol. 2005; 53(3):503-7.
- 8. Caggiati A, De Maeseneer M, Cavezzi A, Mosti G, Morrison N. Rehabilitation of patients with venous diseases of the lower limbs: State of the art. Phlebology. 2018; 33(10):663-71.
- 9. Özdemir ÖC, Sevim S, Duygu E, Tuğral A, Bakar Y. The effects of short-term use of compression stockings on health related quality of life in patients with chronic venous insufficiency. J Phys Ther Sci. 2016; 28(7):1988-92.
- 10. Steins A, Jünger M. Physical therapy in patients with chronic venous insufficiency. Phlebologie. 2000; 29(02):48-53.
- 11. Molski P, Kruczyński J, Molski A, Molski S. Manual lymphatic drainage improves the quality of life in patients with chronic venous disease: a randomized controlled trial. Arch Med Sci. 2013; 9(3):452.
- 12. Molski P, Ossowski R, Hagner W, Molski S. Patients with venous disease benefit from manual lymphatic drainage. Int Angiol. 2009; 28(2):151.
- 13. dos Santos Crisóstomo RS, Costa DSA, Martins CdLB, Fernandes TIR, Armada-da-Silva PA. Influence of manual lymphatic drainage on health-related quality of life and symptoms of chronic venous insufficiency: A randomized controlled trial. Arch Phys Med Rehabil. 2015; 96(2):283-91.
- 14. Crisóstomo R, Candeias M, Armada-da-Silva P. Venous flow during manual lymphatic drainage applied to different regions of the lower extremity in people with and without chronic venous insufficiency: A cross-sectional study. Physiotherapy. 2017; 103(1):81-9.
- 15. Földi E. The treatment of lymphedema. Cancer. 1998; 83(S12B 12B):2833-4.
- 16. Boisseau MR. Leukocyte involvement in the signs and symptoms of chronic venous disease. Perspectives for therapy. Clin Hemorheol Microcirc. 2007; 37(3):277-90.
- 17. Mayrovitz H, Davey S, Shapiro E. Localized tissue water changes accompanying one manual lymphatic drainage (MLD) therapy session assessed by changes in tissue dielectric constant inpatients with lower extremity lymphedema. Lymphology. 2008; 41(2):87-92.
- 18. Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gillespie DL, Gloviczki ML, et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011; 53(5):2S-48S.
- 19. Carpentier P, Cornu-Thenard A, Uhl J, Partsch H, Antignani P. Societe Francaise de Medecine Vasculaire; European Working Group on the Clinical Characterization of Venous Disorders. Appraisal of the information content of the C classes of CEAP clinical classification of chronic venous disorders: a multicenter evaluation of 872 patients. J Vasc Surg. 2003; 37(4):827-33.
- 20. Gardner A, Fox R. The return of blood to the heart: venous pumps in health and disease: Libbey. 1989.
- 21. Sitzia J, Sobrido L, Harlow W. Manual lymphatic drainage compared with simple lymphatic drainage in the treatment of post-mastectomy lymphoedema: a pilot randomised trial. Physiotherapy. 2002; 88(2):99-107.
- 22. Ser TR. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ 1995.
- 23. Mayrovitz HN, Alvarez A, Labra M, Mikulka A, Woody D. Possible applications of normative lower to upper limb ratios of tissue dielectric constant to lower extremity edema. Int Angiol. 2019; 38(1):70-5.
- 24. Lamping DL, Schroter S, Kurz X, Kahn SR, Abenhaim L. Evaluation of outcomes in chronic venous disorders of the leg: development of a scientifically rigorous, patient-reported measure of symptoms and quality of life. J Vasc Surg. 2003; 37(2):410-9.
- 25. Kahn SR, M'lan CE, Lamping DL, Kurz X, Bérard A, Abenhaim LA, et al. Relationship between clinical classification of chronic venous disease and patient-reported quality of life: results from an international cohort study. J Vasc Surg. 2004; 39(4):823-8.
- 26. Çırak Y, Savcı S, Karahan Z, Demirkılıç U. Akut derin ven trombozu sonrası yaşam kalitesi: VEINES-QOL/Sym ölçeğinin kültürel adaptasyonu, güvenirliği ve geçerliği: Türkçe versiyon çalışması. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2013; 21(3):659-68.
- 27. Bellhouse S. Simple lymphatic drainage. Lymphoedema Oxford: Radcliffe Medical Press Ltd. 2000.
- 28. dos Santos Crisóstomo RS, Candeias MS, Ribeiro AMM, da Luz Belo Martins C, Armada-da-Silva PA. Manual lymphatic drainage in chronic venous disease: A duplex ultrasound study. Phlebology. 2014; 29(10):667-76.
- 29. Leduc O, Leduc A, Bourgeois P, Belgrado JP. The physical treatment of upper limb edema. Cancer. 1998; 83(S12B):2835-9.
VENÖZ REFLÜSÜ OLAN VE OLMAYAN, KRONİK VENÖZ HASTALIK TANILI BİREYLERDE MANUEL LENF DRENAJININ LOKAL DOKUDAKİ SU ORANLARI VE YAŞAM KALİTESİ ÜZERİNE ETKİLERİ: PİLOT ÇALIŞMA
Yıl 2022,
Cilt: 7 Sayı: 2, 1 - 11, 17.08.2022
Elif Sakızlı Erdal
,
Abdullah Ozer
,
Emetullah Cindil
,
İlke Keser
Öz
Giriş: Manuel Lenf Drenajı (MLD), Kronik Venöz Yetmezlik (KVY) tanılı hastalarda kullanılabilecek alternatif bir tedavi yaklaşımıdır. Amaç: KVY hastalarında MLD’nin lokal dokudaki su oranları ve yaşam kalitesi üzerine etkilerinin incelenmesidir. Yöntem: Çalışmaya 10 hasta dahil edildi. 0,5 sn üzeri venöz reflüsü olan hastalar KVY grubunu ve venöz reflüsü olmayan bireyler Kronik Venöz Hastalık (KVH) grubunu oluşturdu. Lokal dokudaki su yüzdeleri MoistureMeterD Compact cihazı ile ölçüldü. Yaşam kalitesi Venöz Yetmezliğin Epidemiyolojik ve Ekonomik Çalışması: Yaşam Kalitesi/Belirtiler Ölçeği ile değerlendirildi. Bulgular: KVH hastalarında semptom skoru 32.60±5.68'den 36.40±6.95'e ve toplam yaşam kalitesi skoru 51.8±5.89'dan 55.6±5.32'ye anlamlı olarak arttı. KVY hastalarında semptom skoru 29.00±5.96'dan 34.00±6.12'ye ve toplam yaşam kalitesi skoru 47.20±8.58'den 52.00±5.96'ya anlamlı olarak yükseldi. Yaşam kalitesinde KVY ya da KVH grubunun herhangi birinde daha anlamlı bir iyileşme yoktur (p>0.05). MLD'nin KVH'da lokal dokudan su absorpsiyonuna etkisi vardır, ancak bu azalma istatistiksel olarak anlamlı değildir ve KVY aşamasında yetersizdir (p>0.05). Sonuç: MLD'nin venöz reflü varlığından bağımsız olarak semptomlarda rahatlama ve yaşam kalitesinde iyileşme sağlayabileceği düşünüldü. İleride yapılacak çalışmalarda, daha fazla sayıda hasta bulunan KVY'li hastalarda MLD ile lokal doku suyunun değişimi incelenmelidir.
Kaynakça
- 1. Wittens C, Davies A, Bækgaard N, Broholm R, Cavezzi A, Chastanet S, et al. Editor's choice–management of chronic venous disease: clinical practice guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2015; 49(6):678-737.
- 2. Pocock ES, Alsaigh T, Mazor R, Schmid-Schönbein GW. Cellular and molecular basis of venous insufficiency. Vasc Cell. 2014; 6(1):1-8.
- 3. Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2005; 111(18):2398-409.
- 4. Mortimer PS. Implications of the lymphatic system in CVI-associated edema. Angiology. 2000; 51(1):3-7.
- 5. Raju S, Furrh IV JB, Neglén P. Diagnosis and treatment of venous lymphedema. J Vasc Surg. 2012; 55(1):141-9.
- 6. Morris RJ, Woodcock JP. Evidence-based compression: prevention of stasis and deep vein thrombosis. Ann Surg. 2004; 239(2):162.
- 7. Duque MI, Yosipovitch G, Chan YH, Smith R, Levy P. Itch, pain, and burning sensation are common symptoms in mild to moderate chronic venous insufficiency with an impact on quality of life. J Am Acad Dermatol. 2005; 53(3):503-7.
- 8. Caggiati A, De Maeseneer M, Cavezzi A, Mosti G, Morrison N. Rehabilitation of patients with venous diseases of the lower limbs: State of the art. Phlebology. 2018; 33(10):663-71.
- 9. Özdemir ÖC, Sevim S, Duygu E, Tuğral A, Bakar Y. The effects of short-term use of compression stockings on health related quality of life in patients with chronic venous insufficiency. J Phys Ther Sci. 2016; 28(7):1988-92.
- 10. Steins A, Jünger M. Physical therapy in patients with chronic venous insufficiency. Phlebologie. 2000; 29(02):48-53.
- 11. Molski P, Kruczyński J, Molski A, Molski S. Manual lymphatic drainage improves the quality of life in patients with chronic venous disease: a randomized controlled trial. Arch Med Sci. 2013; 9(3):452.
- 12. Molski P, Ossowski R, Hagner W, Molski S. Patients with venous disease benefit from manual lymphatic drainage. Int Angiol. 2009; 28(2):151.
- 13. dos Santos Crisóstomo RS, Costa DSA, Martins CdLB, Fernandes TIR, Armada-da-Silva PA. Influence of manual lymphatic drainage on health-related quality of life and symptoms of chronic venous insufficiency: A randomized controlled trial. Arch Phys Med Rehabil. 2015; 96(2):283-91.
- 14. Crisóstomo R, Candeias M, Armada-da-Silva P. Venous flow during manual lymphatic drainage applied to different regions of the lower extremity in people with and without chronic venous insufficiency: A cross-sectional study. Physiotherapy. 2017; 103(1):81-9.
- 15. Földi E. The treatment of lymphedema. Cancer. 1998; 83(S12B 12B):2833-4.
- 16. Boisseau MR. Leukocyte involvement in the signs and symptoms of chronic venous disease. Perspectives for therapy. Clin Hemorheol Microcirc. 2007; 37(3):277-90.
- 17. Mayrovitz H, Davey S, Shapiro E. Localized tissue water changes accompanying one manual lymphatic drainage (MLD) therapy session assessed by changes in tissue dielectric constant inpatients with lower extremity lymphedema. Lymphology. 2008; 41(2):87-92.
- 18. Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gillespie DL, Gloviczki ML, et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011; 53(5):2S-48S.
- 19. Carpentier P, Cornu-Thenard A, Uhl J, Partsch H, Antignani P. Societe Francaise de Medecine Vasculaire; European Working Group on the Clinical Characterization of Venous Disorders. Appraisal of the information content of the C classes of CEAP clinical classification of chronic venous disorders: a multicenter evaluation of 872 patients. J Vasc Surg. 2003; 37(4):827-33.
- 20. Gardner A, Fox R. The return of blood to the heart: venous pumps in health and disease: Libbey. 1989.
- 21. Sitzia J, Sobrido L, Harlow W. Manual lymphatic drainage compared with simple lymphatic drainage in the treatment of post-mastectomy lymphoedema: a pilot randomised trial. Physiotherapy. 2002; 88(2):99-107.
- 22. Ser TR. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ 1995.
- 23. Mayrovitz HN, Alvarez A, Labra M, Mikulka A, Woody D. Possible applications of normative lower to upper limb ratios of tissue dielectric constant to lower extremity edema. Int Angiol. 2019; 38(1):70-5.
- 24. Lamping DL, Schroter S, Kurz X, Kahn SR, Abenhaim L. Evaluation of outcomes in chronic venous disorders of the leg: development of a scientifically rigorous, patient-reported measure of symptoms and quality of life. J Vasc Surg. 2003; 37(2):410-9.
- 25. Kahn SR, M'lan CE, Lamping DL, Kurz X, Bérard A, Abenhaim LA, et al. Relationship between clinical classification of chronic venous disease and patient-reported quality of life: results from an international cohort study. J Vasc Surg. 2004; 39(4):823-8.
- 26. Çırak Y, Savcı S, Karahan Z, Demirkılıç U. Akut derin ven trombozu sonrası yaşam kalitesi: VEINES-QOL/Sym ölçeğinin kültürel adaptasyonu, güvenirliği ve geçerliği: Türkçe versiyon çalışması. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2013; 21(3):659-68.
- 27. Bellhouse S. Simple lymphatic drainage. Lymphoedema Oxford: Radcliffe Medical Press Ltd. 2000.
- 28. dos Santos Crisóstomo RS, Candeias MS, Ribeiro AMM, da Luz Belo Martins C, Armada-da-Silva PA. Manual lymphatic drainage in chronic venous disease: A duplex ultrasound study. Phlebology. 2014; 29(10):667-76.
- 29. Leduc O, Leduc A, Bourgeois P, Belgrado JP. The physical treatment of upper limb edema. Cancer. 1998; 83(S12B):2835-9.