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



Douglass, Janet, Mableson, Hayley, Martindale, Sarah, Jhara, Sanya Tahmina, Karim, Mohammad Jahirul, Rahman, Muhammad Mujibur, Al Kawsar, Abdullah, Abul, Khair, Mahmood, ASM Sultan, Rahman, AKM Fazlur
et al (show 5 more authors) (2020) 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. JOURNAL OF CLINICAL MEDICINE, 9 (8). E2444-.

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Abstract

<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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%, -0.68 (-0.91, -0.45), <i>p</i> < 0.001).<h4>Conclusion</h4>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.

Item Type: Article
Uncontrolled Keywords: lymphedema, lymphatic filariasis, self-care, tissue tonometry, lower extremity, massage, breathing
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 13 Jun 2022 08:13
Last Modified: 13 Feb 2024 15:56
DOI: 10.3390/jcm9082444
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3156276