Lymphoedema (LE) is a debilitating condition with the chronic accumulation of interstitial fluid. 1 The permanent pitting stage 2 oedema can evolve into stage 3 non‐pitting oedema with fibrosis and adipose tissue enlargement if remains untreated. Proper control of LE results in ameliorated immune surveillance, less propensity for microbial infections, better function and quality of life. 1 Subsequent to intensive decongestion the application of medical compression stocking (MCS) maintains long‐term volume reduction. 1
ESC Heart Fail. 2021 Oct; 8(5): 4328–4333. Published online 2021 Jul 20. doi: 10.1002/ehf2.13487
PMCID: PMC8497360PMID: 34288554
The effects of lower body compression on left ventricular rotational mechanics in lymphoedema (from the MAGYAR‐Path Study)
Attila Nemes, 1 Árpád Kormányos, 1 Péter Domsik, 1 Anita Kalapos, 1 Lajos Kemény, 2 and Győző Szolnokycorresponding author 2
Overview of the Lymphatic System
ByJames D. Douketis, MD, McMaster University
Reviewed/Revised Apr 2024
Physical treatment for lymphoedema
Process Effect
Exercise Dynamic muscle contractions encourage both passive (movement of lymph along tissue planes and non-contractile lymph vessels) and active (increased contractility of collecting lymph vessels) drainage
Compression (hosiery) Opposes capillary filtration Acts as a counterforce to muscle contractions (so generating greater interstitial pressure changes)
Manual lymphatic drainage Form of massage that stimulates lymph flow in more proximal, normally draining lymphatics to “siphon” lymph from congested areas (particularly trunk)
Multilayer bandaging Used as an intensive treatment in combination with exercise to reduce large, misshapen lower limbs and permit subsequent maintenance treatment with hosiery
Pneumatic compression Softens and reduces limb volume but can forcibly displace fluid into trunk and genitalia. Hosiery must always be worn afterwards
Elevation Does not stimulate lymph drainage but lowers venous pressure and therefore filtration, allowing lymph drainage to catch up
BMJ. 2000 Jun 3; 320(7248): 1527–1529. doi: 10.1136/bmj.320.7248.1527
PMCID: PMC1118110PMID: 10834903
ABC of arterial and venous disease
Swollen lower limb—2: Lymphoedema
Peter S Mortimer
What are physical treatments for lymphedema?
Lymphedema treatment typically includes a combination of physical therapy and garments or bandaging. It moves fluid from areas affected by lymphedema. After physical therapy for lymphedema, it’s very important to use garments or bandaging after therapy to maintain the treatment’s effect.
Physical treatments for lymphedema.
Compression garments: Compression garments may be socks, sleeves or wraps that have pressure to move fluid from your tissues into circulation. This reduces swelling.
Physical therapy: It is a gentle form of massage to stimulate circulation. This is manual lymphatic drainage (MLD). The therapists may teach you how to perform this massage on your own.
Multilayer compression bandaging: If you’ve ever sprained an ankle, you may have put a short stretch bandage on your ankle to keep it from swelling. Multilayer compression bandaging acts the same way on your lymphedema. The bandages put pressure on your tissues, moving fluid back into circulation.
Compression devices: These pneumatic compression pumps provide on-and-off pressure to keep fluid moving through your lymph vessels and veins so it doesn’t build up in your arms, legs and other parts of your body. The devices work by connecting the pump to a sleeve that wraps around your affected areas. The pump drives a regular cycle of pressure that inflates and deflates the sleeve. Compression pumps may also reduce complications of lymphedema.
Elevation: Gravity plays a role in lymphedema symptoms. You should try to keep the affected area of your body elevated as much as possible.
Exercise: Physical exercise is important to stimulate lymphatic drainage.
Indian J Physiol Pharmacol . 2002 Jan;46(1):111-4.
Left ventricular function in varicose veins
K Singh, S Sood
PMID: 12024949
Abstract
Left ventricular function (LVF) was evaluated noninvasively by recording systolic time intervals (STIs) in 25 patients suffering from varicose veins (VV) of lower limbs and compared with 25 age--sex matched controls. STI was measured from simultaneous recordings of electrocardiogram (ECG), carotid arterial pulse (CAP) and phonocardiogram (PCG). The left ventricular ejection time (LVET) was significantly shortened with marked increase in pre-ejection period (PEP) and increase in PEP/LVET ratio (P < 0.001) without any variation in electromechanical systoles (QS2) in VV patients compared to controls. These changes in STI suggest contractility of heart is adversely affected in VV patients.
All-Ireland Lymphoedema Guidelines 2022
Oedema Assessment
Love, Lymphedema and Heart Health
BY ARIA HEALTH
FEBRUARY 14, 2023
Lymphedema and the heart are related in several ways. Lymphedema is the swelling of limbs due to a buildup of lymphatic fluid, which can put an increased strain on the heart. This happens because the heart has to work harder to pump blood and circulate it throughout the body, including the affected limb.
Open Access Article
Effect of an Enhanced Self-Care Protocol on Lymphedema Status among People Affected by Moderate to Severe Lower-Limb Lymphedema in Bangladesh, a Cluster Randomized Controlled Trial
by Janet Douglass 1,*ORCID,Hayley Mableson 1,2,Sarah Martindale 1,Sanya Tahmina Jhara 3,Mohammad Jahirul Karim 3,Muhammad Mujibur Rahman 3,Abdullah Al Kawsar 3,Abul Khair 3,ASM Sultan Mahmood 3,AKM Fazlur Rahman 4,Salim Mahmud Chowdhury 4,Susan Kim 5,Hannah Betts 1,Mark Taylor 1 andLouise Kelly-Hope 1
Journals JCM Volume 9 Issue 8 10.3390/jcm9082444
Background: Lymphatic filariasis (LF) is a major cause of lymphedema, affecting over 16 million people globally. A daily, hygiene-centered self-care protocol is recommended and effective in reducing acute attacks caused by secondary infections. It may also reverse lymphedema status in early stages, but less so as lymphedema advances.
This study offers the first evidence for including lymphatic stimulating activities in recommended self-care for people affected by moderate and severe LF-related lymphedema.
Patients and their caregivers are taught the core components of self-care including washing and drying the affected body parts twice per day, attending to entry lesions and interdigital lesions, range of motion exercises, and limb elevation.
Sloan Kettering Institute
Other ways to reduce risk
Try to avoid crossing your legs as much as possible.
Wear sunscreen with an SPF of 30 or higher to protect your skin from sunburns.
Try to maintain your ideal weight.
Minimize your salt intake. Salt can cause swelling, which may overwhelm your lymphatic system.
Ud. 25.6.2024
Pub. 11.6.2024
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