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
| Autor: | Sarah Martindale, Muhammad Mujibur Rahman, Abdullah Al Kawsar, Sanya Tahmina Jhara, Louise A. Kelly-Hope, Janet Douglass, Abul Khair, Mark J. Taylor, Hannah Betts, Salim Mahmud Chowdhury, Mohammad Jahirul Karim, Asm Sultan Mahmood, Akm Fazlur Rahman, Hayley E. Mableson, Susan Kim |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
breathing Secondary infection 030231 tropical medicine lcsh:Medicine wa_395 massage Disease cluster Article law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine hemic and lymphatic diseases self-care Medicine Cluster randomised controlled trial tissue tonometry lymphatic filariasis Lymphatic filariasis wh_700 Massage business.industry lcsh:R General Medicine lymphedema medicine.disease humanities body regions Lymphedema Lymphatic system 030220 oncology & carcinogenesis wb_327 lower extremity business |
| Zdroj: | Journal of Clinical Medicine Volume 9 Issue 8 Journal of Clinical Medicine, Vol 9, Iss 2444, p 2444 (2020) JOURNAL OF CLINICAL MEDICINE |
| ISSN: | 2077-0383 |
| Popis: | 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. Lymphatic stimulating activities such as self-massage and deep-breathing have proven beneficial for cancer-related lymphedema, but have not been tested in LF-settings. Therefore, an enhanced self-care protocol was trialed among people affected by moderate to severe LF-related lymphedema in northern Bangladesh. Methods: Cluster randomization was used to allocate participants to either standard- or enhanced-self-care groups. Lymphedema status was determined by lymphedema stage, mid-calf circumference, and mid-calf tissue compressibility. Results: There were 71 patients in each group and at 24 weeks, both groups had experienced significant improvement in lymphedema status and reduction in acute attacks. There was a significant and clinically relevant between-group difference in mid-calf tissue compressibility with the biggest change observed on legs affected by severe lymphedema in the enhanced self-care group (∆ 21.5%, &minus 0.68 (&minus 0.91, &minus 0.45), p < 0.001). Conclusion: 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. |
| Databáze: | OpenAIRE |
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