Complex decongestant therapy with use of alternative material to reduce and control lymphedema in patients with endemic area of filariasis: a clinical trial

Authors

  • Helen Pereira dos Santos Soares Faculdade Estácio do Recife. PE. Brasil
  • Abraham Rocha Fundação Oswaldo Cruz; Centro de Pesquisas Aggeu Magalhães; Serviço de Referência Nacional em Filarioses
  • Ana Maria Aguiar-Santos Fundação Oswaldo Cruz; Centro de Pesquisas Aggeu Magalhães; Serviço de Referência Nacional em Filarioses
  • Benícia Santos Silva Faculdade Estácio do Recife. PE. Brasil
  • Cristiane Moutinho Lagos de Melo Faculdade Estácio do Recife. PE. Brasil
  • Maria do Amparo Andrade Universidade Federal de Pernambuco; Departamento de Fisioterapia

DOI:

https://doi.org/10.1590/1809-2950/15476523032016

Abstract

Lymphatic filariasis puts billions of people around the world at risk. Despite this, little is known about the impact of chronic disease morbidity, such as lymphedema. The complex decongestant therapy is a gold standard for treating lymphedemas, but there are no viable protocols for implementation in developing countries. The objective of this clinical trial was to evaluate the efficacy of this technique with the use of alternative material and compare its effects on quality of life, functionality and body weight. The intervention and control groups were evaluated using perimetry and limb volume calculation, the Whoqol-bref quality of life questionnaire, the Functional and Mobility test of the lower limbs Timed Up and Go, and body weight assessment. The intervention group received the complex decongestant therapy twice a week for ten weeks, using an alternative material for the bandaging, made with cambric tissue, which presents low cost in relation to the imported bands. The control group received a lecture with information about the disease and care and hygiene guidelines of the members. The sample consisted of thirty patients with a mean age of 50.8 ± 10 years, 52.9% of whom were women. In the statistical analysis, Student's t test, Multivariate analysis of variance, Wilcoxon test and Kolmogorov-Smirnov test were used. The significance was 5% (p<0.05). There was a significant reduction in lymphedema volume and perimetry in the intervention group, and increased in the control group. The functionality did not show significant improvement in the evaluation by the Timed Up and Go test. The quality of life had significant improvement in the physical and environmental domains in the intervention group. The effect of treatment on body weight was also significant, presenting reduction in the control group and intergroups. Complex decongestant therapy was effective in reducing and controlling lymphedema and positively impacted, increasing the numerical values of the physical and environmental aspects of the quality of life of the intervention group.

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References

World Health Organization. Lymphatic filariasis. Genebra:

Who; 2015.

World Health Organization. The regional strategic plan for

elimination of lymphatic filariasis 2010-2015. Genebra: Who;

Ottesen EA. Infection and disease in lymphatic

filariasis: an immunological perspective. Parasitology.

;104(Suppl):S571-9.

Addis DG, Brady MA. Morbidity management in the Global

Programme to Eliminate Lymphatic Filariasis: a review of the

scientific literature. Filaria J. 2007;6(2):1-19.

Rocha A, Marcondes M, Nunes JRV, Miranda T, Veiga J,

Araújo P, Tenório W, Aguiar-Santos A. Programa de controle

e eliminação da filariose linfática: uma parceria da Secretaria

de Saúde de Olinda-PE, Brasil, com o Serviço de Referência

Nacional em Filarioses. Rev Patol Trop. 2010;9(3):233-49.

Adhikari RK, Sherchand JB, Mishra SR, Ranabhat K, Wagle

RR. Quality of life of people living with lymphedema: a cross

sectional community based study in selected districts of

Nepal. J Inst Med. 2014;36(1):69-75.

Krishna Kumari A, Krishnamoorty K, Harichandrakumar K,

Das L. Health related quality of life, an appropriate indicator

to assess the impact of morbidity management and disability

prevention activities towards elimination of lymphatic

filariasis. Filaria J. 2007;6(8).

Albuquerque MFPM. Urbanization, slums, and endemics: the

production of filariasis in Recife, Brazil. Cad Saúde Pública.

;9(4):487-97.

International Society of Lymphology. The diagnosis and

treatment of peripheral lymphedema: Consensus document

of the International Society of Lymphology. Lymphology.

;46(1):1-11.

Medeiros Z, Dreyer G, Andrade LD, Pires ML, Mendes J,

Pimentel R: Wuchereria Bancrofti microfilarial density of

autochthonous cases and natural Culex infectivity rates in

Northeast Brazil. J Trop Med Hyg. 1992;95(3):214-7.

Pani SP, Srividya A. Clinical manifestations of bancrofti a

filariasis with special reference to lymphedema grading.

Indian J Med Res. 1995;102:114-8.

Fontes G, Leite AB, Lima ARV, Freitas H, Ehrenberg JP,

Rocha EMM. Lymphatic filariasis in Brazil: epidemiological

situation and outlook for elimination. Parasites Vectors.

;5(272):1-11.

Rocha EMM, Fontes G. Filariose bancroftiana no Brasil. Rev

Saúde Pública. 1998;32(1):98-105.

Casley-Smith JR. Alterations of untreated lymphedema and

its grades over time. Lymphology. 1995;28(4):174-85.

Dreyer G, Addiss D, Roberts J, Norões J. Progression

of lymphatic vessel dilatation in the presence of living

adult Wuchereria bancrofti. Trans R Trop Med Hyg.

;96(2):157-61.

MacLaren JÁ. Skin changes in lymphoedema:

pathophysiology and management options. Int J Palliat Nurs.

;7(8):381-8.

Dunberger G, Lindquist H, Waldenström AC, Nyberg T,

Steineck G, Avall-Lundquivist E. Lower limb lymphedema

in gynecological cancer survivors: effect on daily life

functioning. Support Care Cancer. 2013;21(11):3063-70.

Földi M, Földi E, Kubik S. Textbook of lymphology for

physicians and lymphedema therapists. Munich: Urban &

Fischer; 2006.

Preston NJ, Seers K, Mortimer PS. Physical therapies for

reducing and controlling lymphoedema of the limbs.

Cochrane Database Syst Rev. 2004;18(4):CD003141.

Tacani PM, Machado AFP; Tacani RE. Abordagem

fisioterapêutica do linfedema bilateral de membros inferiores.

Fisioter Mov. 2012;25(3):561-70.

Yamamoto R, Yamamoto T. Effectiveness of the treatmentphase of two-phase complex decongestive physiotherapy

for the treatment of extremity lymphedema. Int J Clin Oncol.

;12(6):463-8.

Fleck MPA, Xavier M, Chachamovich SLE, Vieira G, Santos L,

Pinzon V. O instrumento de avaliação de qualidade de vida

abreviado da Organização Mundial de Saúde (WHOQOLbreve): aplicação da versão em português. Rev Saúde

Pública. 2000;34(2):178-83.

Podsiadlo D, Richardson S. The timed “Up & Go”: a test of

basic functional mobility for frail elderly persons. J Am

Geriatr Soc. 1991;39(2):142-8.

Addiss DG, Louis-Charles J, Roberts J, Le Conte F, Wendt

JM, Milord MD, et al. Feasibility and effectiveness of basic

lymphedema management in Leogane, Haiti, an area

endemic for Bancroftian Filariasis. PLoS Negl Trop Dis.

;4(4):e668.

Gethin G, Byrne D, Tierney S, Strapp H, Cowman S. Prevalence

of lymphedema and quality of life among patients attending

a hospital-based wound management and vascular clinic. Int

Wound J. 2011;9(2):120-5.

Deltombe T, Jamart J, Recloux S, Legrand C, Vandenbroeck

N, Theys S, et al. Reliability and limits of agreement of

circumferential, water displacement, and optoelectronic

volumetry in the measurement of upper limb lymphedema.

Lymphology. 2007;40(1):26-34.

Kim SJ, Park YD. Effects of complex decongestive

physiotherapy on the oedema and the quality of

life of lower unilateral lymphoedema following

treatment for gynecological cancer. Eur J Cancer Care.

;17(5):463-8.

McPherson T. Impact on the quality of life of lymphedema

patients following introduction of a hygiene and skin care

regimen in a Guyanese community endemic for lymphatic

filariasis: a preliminary clinical intervention study. Filaria J.

;2(1):2-5.

Moseley AL, Carati CJ, Piller NB. A systematic review of

common conservative therapies for arm lymphoedema

Soares et al. Terapia descongestiva na redução e controle do linfedema

secondary to breast cancer treatment. Ann Oncol.

;18(4):639-46.

Oremus M, Dayes I, Walker K, Raina P. Systematic review:

conservative treatments for secondary lymphedema. BMC

Cancer. 2012;12:6.

Preston NJ, Seers K, Mortimer PS. Physical therapies for

reducing and controlling lymphoedema of the limbs.

Cochrane Database of Syst Rev. 2004;4.

Budge PJ, Little KM, Mues KE, Kennedy ED, Prakash A,

Rout J, Fox LM. Impact of community-based lymphedema

management on perceived disability among patients with

lymphatic filariasis in Orissa State, India. Plos Negl Trop Dis.

;7(3):e2100.

World Health Organization. Weekly epidemiological record.

[acesso em 4 nov. 2016];87(37):345-56. Disponível em:

http://bit.ly/2fD00Hl

Thomas C, Narahari SR, Bose KS, Vivekananda K, Nwe S,

West DP, et al. Comparison of three quality of life instruments

in lymphatic filariasis: DLQI, WHODAS 2.0, and LFSQQ. PLoS

Negl Trop Dis. 2014;8(2):e2716.

Okajima RMO, Freitas THP, Zaitz C. Estudo clínico de 35

pacientes com diagnóstico de erisipela internados no

Hospital Central da Irmandade da Santa Casa de Misericórdia

de São Paulo. An Bras Dermatol. 2004;79(3):295-303.

Ramaiah KD, Radhamani MP, John KR, Evans DB, Guyatt H,

Joseph A, et al. The impact of lymphatic filariasis on labour

inputs in south India: results of a multi-site study. Ann Trop

Med Parasitol. 2000;94(4):353-64.

Ravindran B. Aping Jane Goodall: Insights into human

lymphatic filariasis. Trends Parasitol. 2003;19(3):105-9.

Ramu K, Ramaiah KD, Guyatt H, Evans D. Impact of lymphatic

filariasis on the productivity of male weavers in a South

Indian village. Trans R Soc Trop Med Hyg. 1996;90(6):669-70

Published

2016-09-09

Issue

Section

Original Research

How to Cite

Complex decongestant therapy with use of alternative material to reduce and control lymphedema in patients with endemic area of filariasis: a clinical trial . (2016). Fisioterapia E Pesquisa, 23(3), 268-277. https://doi.org/10.1590/1809-2950/15476523032016