Issue №5-20, 2021

Original article

https://doi.org/10.38025/2078-1962-2021-20-5-12-18

The Lymphatic Pump Technique for the Treatment of the Lower Limb Lymphedema

View article (Download PDF file)



Download XML file

1 ORCIDBergna A., 1 ORCIDPanigada L., 1 ORCIDBenussi F., 1 ORCIDBuffone F., 1 ORCIDCaruana C., 1 ORCIDCastrignano M., 1 ORCIDCiancone E., 1 ORCIDCazzaniga F., 1 ORCIDSotgiu A., 1,2 ORCIDBressan V., 1,3 ORCIDBressan L.C., 4 ORCIDSolimene U.

1 SOMA Institute of Osteopathy, Milan, Italy
2 Hospice «Nucleus», Geriatric Institute Golgi-Redaelli, Milan, Italy
3 Bassini hospital, Azienda Socio Sanitaria Territoriale, Milan, Italy
4 Milan State University, World Federation of Hydrotherapy «FEMTEC», Milan, Italy


ABSTRACT

Lymphedema is a condition occurring when the lymphatic system fails to efficiently transport the lymph, thus creating a fluid accumulation in the interstitial space. As of today, the rehabilitation treatment for lymphedema relies on the principles of Complete Decongestive Therapy (CDT), a series of treatments designed to favor the reabsorption of the lymph by the lymphatic system and to restore the functionality of the affected limb. From an osteopathic point of view, interesting results have been obtained through Lymphatic Pump Technique (LPT), a series of oscillatory techniques applied to different areas of the body such as chest, abdomen and feet. A few LPT studies on animals have shown a significant improvement not only in the lymphatic system efficiency (an increase of 271% in lymph flow) but also in the immune system.

AIM. From the scientific evidence derived from such studies, in this paper we propose a clinical trial aiming to demonstrate the benefits that this technique can bring to human beings in a specific rehabilitation process following a lower limb lymphoedema.

MATERIAL AND METHODS. An indirect volumetric measurement of lymphedematous limbs according to the segmental technique was performed on six subjects having a history of CDT treatments with different clinical histories, age, gender, work and sport characteristics.The results of the study group treated with the LPT were compared to the results of the same subjects who previously underwent CDT treatment only. The LPT was applied in 8 sessions for two weeks, i.e. for the period of time scheduled for normal physiotherapy rehabilitation including CDT.

RESULTS. The average volume before CDT was 9470.6 ml while after treatment was 8429 ml. The mean volume before CDT associated with LPT was 9608.5 ml, whereas after treatment the mean was 8267 ml with a significant reduction in lymphoedema.

CONCLUSIONS. Despite the small number of cases examined, the treatment described in this project has led to positive and statistically significant results, in terms of absorption of lymphedema, especially reducing the volume of the limb. LPT is safe as it is a non-invasive technique, performed with the application of light forces, and integrates perfectly with the CDT.


KEYWORDS: complete decongestive therapy, lymphatic pump treatment, lymphedema

Acknowledgments: The study had no sponsorship

Conflict of interest:: The authors declare no apparent or potential conflicts of interest related to the publication of this article.

For citation: Bergna A., Panigada L., Benussi F., Buffone F., Caruana C., Castrignano M., Ciancone E., Cazzaniga F., Sotgiu A., Bressan V., Bressan L.C., Solimene U. The Lymphatic Pump Technique for the treatment of the Lower Limb Lymphedema. Bulletin of Rehabilitation Medicine. 2021; 20 (5): 12-18. https://doi.org/10.38025/2078-1962-2021-20-5-12-18

For correspondence: Luca Panigada, e-mail: lamaildilucapanigada@gmail.com



References:

  1. Cheville A.L., McGarvey C.L., Petrek J.A., Russo S.A., Taylor M.E., Thiadens S.R. Lymphedema management. Seminars in Radiation Oncology. 2003; (13): 290-301.
  2. Mcadonza N., Li A., Gill A., Tyring S. Filariasis: diagnosis and treatment. Dermatologic Therapy. 2009; 22(6); 475-90.
  3. Smeltzer D.M., Stickler G.B., Schirger A. Primary lymphoedemas in children and adolescents: a follow up study and review. Pediatrics. 1985; (76): 206-18.
  4. Wolfe J., Kinmonth J.B. The prognosys of primary lymphoedema of the lower limbs. Archives of Surgery. 1981; (116): 1157-60.
  5. Schnok C.C., Mulliken J.R., Fishman S.J., Grant F., Zurakowski D., Greene A.K. Primary lymphoedema: clinical fetures and menagement in 138 pediatric patients. Plastic and Reconstructive Surgery. 2011; (127): 2419-31.
  6. Rockson S.H., Rivera K.K. Estimating the population burden of lymphedema. Annals of the New York Academy of Sciences. 2008; (113); 147-54.
  7. Van der Zee A.G., Oonk M.H., De Hullu J.A., Ansink A.C., Vergote I., Verheijen R.H., Maggioni A., Gaarenstroom K.N., Baldwin P.J., Van Dorst E.B., Vander Velden J., Hermans R.H., Vander Putten H., Drouin P., Schneider A., Sluiter W.J. Sentinel node dissection is safe in the treatment of early-stage vulvar cancer. Journal of Clinical Oncology. 2008; (26): 884-9.
  8. Lawenda B.D., Mondry T.E., Johnstone P.A. Lymphedema: a primer on the identification and management of a chronic condition in oncologic treatment. CA: A Cancer Journal for Clinicians. 2009; 59(1): 8-24.
  9. Ko D.S., Lerner R., Klose G., Cosimi A.B. Effective treatment of lymphedema of the extremities. Archives of Surgery. 1998; 133(4): 452-8.
  10. Tambour M., Tange B., Christensen R., Gramcorresponding B. Effect of physical therapy on breast cancer related lymphedema: protocol for a multi -center, randomized, single- blind, equivalence trial. BMC Cancer. 2014; (14): 239 p.
  11. The diagnosis and treatment of peripheral lymphedema: 2013 Consensus. Document of the International Society of Lymphology. Lymphology. 2013; 46(1): 1-11.
  12. Lasinski B.B., Thrift K.M., Squire D., Austin M.K., Smith K.M., Wanchai A., Green J.M., Stewart B.R., Cormier J.N., Armer J.M. A systematic review of the evi -dence for complete decongestive therapy in the treatment of lymphedema from 2004 to 2011. PM&R: The Journal of Injury, Function and Rehabilitation. 2012; 4(8): 580-601.
  13. Viñas F. Drenaggio linfatico manuale. Guida completa per applicazioni mediche ed estetiche. 9th ed. Como: Red edizioni. 2003.
  14. Thompson B., Gaitatzis K., Janse de Jonge X., Blackwell R., Koelmeyer L.A. Manual lymphatic drainage treatment for lymphedema: a systematic review of the literature. Journal of Cancer Survivorship. 2021; (15): 244-258.
  15. Farina G. Procedure algoritmiche applicate alla terapia compressive: tecnica moderna di bendaggio linfologico. Giornale Italiano di Linfologia. 2012; 1(1): 17-21.
  16. Dionne A., Goulet S., Leone M., Comtois A.S. Aquatic Exercise Training Outcomes on Functional Capacity, Quality of Life, and Lower Limb Lymphedema: Pilot Study. Journal of Alternative and Complementary Medicine. 2018; 24(9-10): 1007-1009.
  17. American Association of Colleges of Osteopathic Medicine, 2017. Glossary of Osteopathic Terminology. Available at: http://www.aacom.org/news-and-events/publications/glossary-of-osteopathic-terminology (accessed 23.09.2021)
  18. Schander A., Padro D., King H.H., Downey H.F., Hodge L.M. Lymphatic Pump Treatment reapeatedly enhances the lymphatic and immune systems. Lymphatic Research and Biology. 2013; 11(4): 219-26.
  19. Hodge L.M., Bearden M.K., Schander A., Huff J.B., Williams A., King H., Downey H.F. Lymphatic pump treatment mobilizes leukocytes from the gut associ-ated lymphoid tissue into lymph. Lymphatic Research and Biology. 2010; 8(2): 103-10.
  20. Huff B.J., Schander A., Downey H.F., Hodge L.M. Lymphatic pump treatment auguments lymphatic flux of lymphocytes in rats. Lymphatic Research and Biology. 2010; 8(4); 183-7.
  21. Hodge L.M., Downey H.F. Lymphatic pump treatment enhances the lymphatic and immune system. Experimental Biology and Medicine. 2011; (236): 1109-1115.
  22. Creasy C., Schander A., Orlowski A., Hodge L.M. Thoracic and abdominal lymphatic pump techniques inhibit the growth of S. pneumoniae bacteria in the lungs of rats. Lymphatic Research and Biology. 2013; 11(3): 183-6.
  23. Yao S., Hassani J., Gagne M., George G., Gilliar W. Osteopathic Manipulative Treatment as a useful adjunctive tool for pneumonia. Journal of Visualized Experiments. 2014; (87): 50687 p.
  24. Noll D.R., Degenhardt B.F., Stuart M., Mc Govern R., Matteson M. Effectiveness of a sham protocol and adverse effects in a clinical trial of osteopathic manipulative treatment in nursing homepatients. Journal of Osteopathic Medicine . 2004; (104): 107-13.
  25. Farina G., Zappa G., Porcella E., Tacchetti G., Bartoletti R., Stasi E., Riboli A., Cappello S., Campo G. Misurazione Volumetrica indiretta degli arti linfedema -tosi secondo la tecnica segmentaria. Giornale Italiano di Linfologia. 2013; 2(1): 3-17.
  26. Badtieva V.A., Apkhanova T.V. Lymphedema of the lower extremities: modern aspects of complex conservative treatment. Phlebology. 2010; 4(3): 55-60.
  27. Apkhanova T.V., Kulchitskaya D.B., Eremushkin M.A., Styazhkina E.M. The application of therapeutic gymnastics in the pool in rehabilitation of patients with chronic lymphovenous insufficiency of the lower limbs. Bulletin of Rehabilitation Medicine. 2019; 3(91): 20-24.



Creative Commons License
The content is available under the Creative Commons Attribution 4.0 License.

©

Эта статья открытого доступа по лицензии CC BY 4.0. Издательство: ФГБУ «НМИЦ РК» Минздрава России.
This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.