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Addition of Lymphatic Stimulating Self-Care Practices Reduces Acute Attacks among People Affected by Moderate and Severe Lower-Limb Lymphedema in Ethiopia, a Cluster Randomized Controlled Trial

Lymphedema causes disability and exacerbates poverty in many countries. The management of lymphatic filariasis (LF) and podoconiosis-related lymphedema involves daily hygiene to reduce secondary infections, but self-massage and deep-breathing, which have proven beneficial in cancer-related lymphedem...

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Autores principales: Douglass, Jan, Hailekiros, Fikre, Martindale, Sarah, Mableson, Hayley, Seife, Fikre, Bishaw, Tesfahun, Nigussie, Mekdes, Meribo, Kadu, Tamiru, Mossie, Agidew, Getnet, Kim, Susan, Betts, Hannah, Taylor, Mark, Kelly-Hope, Louise
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766500/
https://www.ncbi.nlm.nih.gov/pubmed/33348721
http://dx.doi.org/10.3390/jcm9124077
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author Douglass, Jan
Hailekiros, Fikre
Martindale, Sarah
Mableson, Hayley
Seife, Fikre
Bishaw, Tesfahun
Nigussie, Mekdes
Meribo, Kadu
Tamiru, Mossie
Agidew, Getnet
Kim, Susan
Betts, Hannah
Taylor, Mark
Kelly-Hope, Louise
author_facet Douglass, Jan
Hailekiros, Fikre
Martindale, Sarah
Mableson, Hayley
Seife, Fikre
Bishaw, Tesfahun
Nigussie, Mekdes
Meribo, Kadu
Tamiru, Mossie
Agidew, Getnet
Kim, Susan
Betts, Hannah
Taylor, Mark
Kelly-Hope, Louise
author_sort Douglass, Jan
collection PubMed
description Lymphedema causes disability and exacerbates poverty in many countries. The management of lymphatic filariasis (LF) and podoconiosis-related lymphedema involves daily hygiene to reduce secondary infections, but self-massage and deep-breathing, which have proven beneficial in cancer-related lymphedema, are not included. A cluster randomized trial in northern Ethiopia investigated the effects of lymphatic stimulation for people affected by moderate to severe lymphedema. Participants were allocated to either standard (control n = 59) or enhanced (intervention n = 67) self-care groups. Primary outcomes were lymphedema stage, mid-calf circumference, and tissue compressibility. Secondary outcomes were the frequency and duration of acute attacks. After 24 weeks, fewer patients were assessed as severe (control −37.8%, intervention −42.4%, p = 0.15) and there were clinically relevant changes in mid-calf tissue compressibility but not circumference. There was a significant between-group difference in patients who reported any acute attacks over the study period (control n = 22 (38%), intervention n = 7 (12%), p = 0.014). Daily lymphedema self-care resulted in meaningful benefits for all participants with a greater reduction in acute episodes among people performing lymphatic stimulation. Observations of a change in lymphedema status support earlier findings in Bangladesh and extend the demonstrated benefits of enhanced self-care to people affected by podoconiosis.
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spelling pubmed-77665002020-12-28 Addition of Lymphatic Stimulating Self-Care Practices Reduces Acute Attacks among People Affected by Moderate and Severe Lower-Limb Lymphedema in Ethiopia, a Cluster Randomized Controlled Trial Douglass, Jan Hailekiros, Fikre Martindale, Sarah Mableson, Hayley Seife, Fikre Bishaw, Tesfahun Nigussie, Mekdes Meribo, Kadu Tamiru, Mossie Agidew, Getnet Kim, Susan Betts, Hannah Taylor, Mark Kelly-Hope, Louise J Clin Med Article Lymphedema causes disability and exacerbates poverty in many countries. The management of lymphatic filariasis (LF) and podoconiosis-related lymphedema involves daily hygiene to reduce secondary infections, but self-massage and deep-breathing, which have proven beneficial in cancer-related lymphedema, are not included. A cluster randomized trial in northern Ethiopia investigated the effects of lymphatic stimulation for people affected by moderate to severe lymphedema. Participants were allocated to either standard (control n = 59) or enhanced (intervention n = 67) self-care groups. Primary outcomes were lymphedema stage, mid-calf circumference, and tissue compressibility. Secondary outcomes were the frequency and duration of acute attacks. After 24 weeks, fewer patients were assessed as severe (control −37.8%, intervention −42.4%, p = 0.15) and there were clinically relevant changes in mid-calf tissue compressibility but not circumference. There was a significant between-group difference in patients who reported any acute attacks over the study period (control n = 22 (38%), intervention n = 7 (12%), p = 0.014). Daily lymphedema self-care resulted in meaningful benefits for all participants with a greater reduction in acute episodes among people performing lymphatic stimulation. Observations of a change in lymphedema status support earlier findings in Bangladesh and extend the demonstrated benefits of enhanced self-care to people affected by podoconiosis. MDPI 2020-12-17 /pmc/articles/PMC7766500/ /pubmed/33348721 http://dx.doi.org/10.3390/jcm9124077 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Douglass, Jan
Hailekiros, Fikre
Martindale, Sarah
Mableson, Hayley
Seife, Fikre
Bishaw, Tesfahun
Nigussie, Mekdes
Meribo, Kadu
Tamiru, Mossie
Agidew, Getnet
Kim, Susan
Betts, Hannah
Taylor, Mark
Kelly-Hope, Louise
Addition of Lymphatic Stimulating Self-Care Practices Reduces Acute Attacks among People Affected by Moderate and Severe Lower-Limb Lymphedema in Ethiopia, a Cluster Randomized Controlled Trial
title Addition of Lymphatic Stimulating Self-Care Practices Reduces Acute Attacks among People Affected by Moderate and Severe Lower-Limb Lymphedema in Ethiopia, a Cluster Randomized Controlled Trial
title_full Addition of Lymphatic Stimulating Self-Care Practices Reduces Acute Attacks among People Affected by Moderate and Severe Lower-Limb Lymphedema in Ethiopia, a Cluster Randomized Controlled Trial
title_fullStr Addition of Lymphatic Stimulating Self-Care Practices Reduces Acute Attacks among People Affected by Moderate and Severe Lower-Limb Lymphedema in Ethiopia, a Cluster Randomized Controlled Trial
title_full_unstemmed Addition of Lymphatic Stimulating Self-Care Practices Reduces Acute Attacks among People Affected by Moderate and Severe Lower-Limb Lymphedema in Ethiopia, a Cluster Randomized Controlled Trial
title_short Addition of Lymphatic Stimulating Self-Care Practices Reduces Acute Attacks among People Affected by Moderate and Severe Lower-Limb Lymphedema in Ethiopia, a Cluster Randomized Controlled Trial
title_sort addition of lymphatic stimulating self-care practices reduces acute attacks among people affected by moderate and severe lower-limb lymphedema in ethiopia, a cluster randomized controlled trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766500/
https://www.ncbi.nlm.nih.gov/pubmed/33348721
http://dx.doi.org/10.3390/jcm9124077
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