Complex decongestant therapy with use of alternative material to reduce and control lymphedema in patients with endemic area of filariasis: a clinical trial
DOI:
https://doi.org/10.1590/1809-2950/15476523032016Abstract
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.Downloads
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:
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
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