LymphedemaV1, Main, Curation, bibRecord, 00D346

MODERN TREATMENT OF LYMPHOEDEMA I. COMPLEX PHYSICAL THERAPY: THE FIRST 200 AUSTRALIAN LIMBS

Identifieur interne : 00D346 ( Main/Curation ); précédent : 00D345; suivant : 00D347

MODERN TREATMENT OF LYMPHOEDEMA I. COMPLEX PHYSICAL THERAPY: THE FIRST 200 AUSTRALIAN LIMBS

Auteurs : Judith R. Casley-Smith [Australie] ; John R. Casley-Smith

Source :

Australasian Journal of Dermatology [ 0004-8380 ] ; 1992-08.

RBID : ISTEX:2628AD3268E52DB44CE659861041473411257D95

Abstract

Complex Physical Therapy (CPT) is discussed and its principles outlined. CPT involves: 1. skin care, 2. a special lymphatic massage, 3. compression bandaging and (later) garments, 4. special exercises which supplement the massage. CPT was used on 78 patients with postmastectomy lymphoedema (17 with Grade 1 and 61 with Grade 2). There were significant differences between the Grades. In the first four‐week course the mean Grade 1 was reduced from 121% of normal to 107% (the mean change in the oedema was 103% of its initial value), and Grade 2 from 153% to 123% (with a mean change in oedema of 60%). All these were very highly significant. Over the next year there was a small, but very significant, decrease in the percentage of oedema. A further four‐week course resulted in significant, and similar, reductions in the residual oedema. CPT was used to treat 128 lymphoedematous legs; 22 were Grade 1 lymphoedema, 84 were Grade 2 and 19 were elephantitic (Grade 3). After the first course of CPT the mean losses were: 1.1, 1.3 and 3.7 litres, respectively (all very significant). Over the next 11 months there were significant further reductions for all legs and in the amount of oedema of the unilateral legs. Some patients had a second course of CPT with similar reductions in the remaining oedema to that after the first course.

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DOI: 10.1111/j.1440-0960.1992.tb00081.x

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John R. Casley-Smith

<affiliation><wicri:noCountry code="subField">Adelaide.</wicri:noCountry>
</affiliation>

Le document en format XML

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<front><div type="abstract" xml:lang="en">Complex Physical Therapy (CPT) is discussed and its principles outlined. CPT involves: 1. skin care, 2. a special lymphatic massage, 3. compression bandaging and (later) garments, 4. special exercises which supplement the massage. CPT was used on 78 patients with postmastectomy lymphoedema (17 with Grade 1 and 61 with Grade 2). There were significant differences between the Grades. In the first four‐week course the mean Grade 1 was reduced from 121% of normal to 107% (the mean change in the oedema was 103% of its initial value), and Grade 2 from 153% to 123% (with a mean change in oedema of 60%). All these were very highly significant. Over the next year there was a small, but very significant, decrease in the percentage of oedema. A further four‐week course resulted in significant, and similar, reductions in the residual oedema. CPT was used to treat 128 lymphoedematous legs; 22 were Grade 1 lymphoedema, 84 were Grade 2 and 19 were elephantitic (Grade 3). After the first course of CPT the mean losses were: 1.1, 1.3 and 3.7 litres, respectively (all very significant). Over the next 11 months there were significant further reductions for all legs and in the amount of oedema of the unilateral legs. Some patients had a second course of CPT with similar reductions in the remaining oedema to that after the first course.</div>
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<front><div type="abstract" xml:lang="en">Complex Physical Therapy (CPT) is discussed and its principles outlined. CPT involves: 1. skin care, 2. a special lymphatic massage, 3. compression bandaging and (later) garments, 4. special exercises which supplement the massage. CPT was used on 78 patients with postmastectomy lymphoedema (17 with Grade 1 and 61 with Grade 2). There were significant differences between the Grades. In the first four‐week course the mean Grade 1 was reduced from 121% of normal to 107% (the mean change in the oedema was 103% of its initial value), and Grade 2 from 153% to 123% (with a mean change in oedema of 60%). All these were very highly significant. Over the next year there was a small, but very significant, decrease in the percentage of oedema. A further four‐week course resulted in significant, and similar, reductions in the residual oedema. CPT was used to treat 128 lymphoedematous legs; 22 were Grade 1 lymphoedema, 84 were Grade 2 and 19 were elephantitic (Grade 3). After the first course of CPT the mean losses were: 1.1, 1.3 and 3.7 litres, respectively (all very significant). Over the next 11 months there were significant further reductions for all legs and in the amount of oedema of the unilateral legs. Some patients had a second course of CPT with similar reductions in the remaining oedema to that after the first course.</div>
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<placeName><region type="state">Australie-Méridionale</region>
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<idno type="eISSN">1440-0960</idno>
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<front><div type="abstract" xml:lang="en">The benzo‐pyrones reduce all high‐protein oedemas, including lymphoedema and elephantiasis, by increasing the numbers of macrophages and their normal proteolysis. Thus they remove the excess protein, and thereby the oedema which is caused by it. They also remove the stimulus it provides for chronic inflammation and fibrosis, and its action as a culture medium for bacteria. Coumarin (5,6 benzo‐[alpha]‐pyrone, 56 BaP) and oxerutins (HR, O(β‐hydroxy‐ethyl)‐rutosides) have been used in many clinical trials on a variety of high‐protein oedemas. Four such trials are summarised here: on lymphoedema and elephantiasis (from many causes in Australia, and filaritic in India and China). The drugs reduced these much more slowly than adequate physical therapy, but they did reduce them. About half the excess volume was removed over six months in the Australian trials. In India and China similar rates were achieved with lymphoedema, but elephantiasis reduced at a slower rate. The benzo‐pyrones convert a slowly worsening condition into a slowly improving one. No compression garments are necessary. In addition, the drugs considerably reduce the number of attacks of secondary acute infection, reduce the deformities of elephantiasis and considerably improve the patients'comfort and mobility. They may be taken orally, or applied topically, have very low toxicities and only few, minor side‐effects. They are useful in many other forms of high‐protein oedema, and improve the results of physical therapy for lymphoedema.</div>
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MODERN TREATMENT OF LYMPHOEDEMA I. COMPLEX PHYSICAL THERAPY: THE FIRST 200 AUSTRALIAN LIMBS

MODERN TREATMENT OF LYMPHOEDEMA I. COMPLEX PHYSICAL THERAPY: THE FIRST 200 AUSTRALIAN LIMBS

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Abstract

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