Effectiveness of manual lymphatic drainage associated with functional banding in the clinical improvement of gynoid lipodystrophy in pregnant women: a clinical, controlled and randomized trial
DOI: 10.15343/0104-7809.202145010023
Keywords:
Manual Lymphatic Drainage, Massage, Compressive Bandages, Pregnant Women, Cellulite.Abstract
During pregnancy, women can trigger hormonal dysfunctions that induce the accumulation of edema and fibrotic nodules, favoring the formation of rifted skin causing a painful sensation. Therefore, this study aimed to compare the effectiveness of manual lymphatic drainage with or without the use of functional bandages in gynoid lipodystrophy (GLD) in pregnant women in the second and third trimester. This was a randomized clinical trial, composed of three groups: G1: Manual Lymphatic Drainage (MLD); G2: MLD + Functional Bandage (FB); G3: Control Group. Inclusion criteria: pregnant women in the second and third trimester, primiparous or multiparous and a single fetus pregnancy. MLD was performed in the gluteal region and lower limbs, and FB was applied from the inguinal region in the form of a web directed to the medial gluteal region, using a surface tension of 10%. An evaluation protocol for gynoid lipodystrophy (EPGLD) with anamnesis, a physical examination with an inspection, a grip test, tactile sensitivity test (Semmes-Weinstein monofilament test), assessing the patient’s sensitivity, grade, pain, recommendation, and satisfaction was used. Photos were taken of the gluteus region before and after and were then evaluated by 10 specialists through photogrammetry. There was a significant clinical improvement in the drainage group and in the association with the bandage when compared to the control group by the 10 specialists. There was a significant improvement in the scores of specialists in groups G1 and G2, when compared to G3. Therefore, the present study demonstrated a clinical improvement in gynoid lipodystrophy of pregnant women who received MLD alone, and in association with FB, when compared to the control group.
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2. Silva RMV, Cavalcanti RL, Rêgo LMF, Nunes PFL, Meyer PF. Effects of Kinesio Taping® in treatment of Cellulite: Randomized controlled blind trial. Manual Therapy, Posturology & Rehabilitation Journal. 2014. 12, 106-111. dx.doi.org/ 10.17784/mtprehabjournal.2014.12.175
3. Santana AP, Uchôa EPBL. Physiotherapeutic evaluation in women with fibro edema geloid in a clinic in Recife city – PE. Rev. Inspirar – Movimento e Saude. 2015. 7(4), 20-28. doi: 10.13037/rbcs.vol12n42.2339
4. Silva VMR, Meyer FP, Delgado MA, Oliveira SJ, Soares PJI, Costa et al. Correlação entre o fibroedemagelóide e dosagem de estradiol. Revista Científica da Cscola da saúde. 2013. 1(18), 25-34. https://repositorio.unp.br/index.php/catussaba/article/view/235
5. Pinto e Silva MP, Bassani MA, Miquelutti MA, Marques Ade A, do Amaral MT, de Oliveira MM et al. Manual lymphatic drainage and multilayer compression therapy for vulvar edema: a case series. Physiother Theory Pract. 2015. 31(7), 527-31. doi: 10.3109/09593985.2015.1038375.
6. Leduc O, Leduc A. Rehabilitation protocol in upper limb lymphedema. Ann Ital Chir. 2002. 73(5), 479-84. https://pubmed.ncbi.nlm.nih.gov/12704986/
7. Leduc O, Crasset V, Leleu C, Baptiste N, Koziel A, Delahaie C et al. Impact of manual lymphatic drainage on hemodynamic parameters in patients with heart failure and lower limb edema. Lymphology. 2011. 44(1):13-20. https://pubmed.ncbi.nlm.nih.gov/21667818/
8. Artioli DP, Bertolin GRF. Kinesio taping: application and results on pain: systematic review. Revista Fisioterapia Pesquisa. 2014. 21(1), 94-99. doi.org/10.1590/1809-2950/553210114
9. Melgaard D. What is the effect of treating secondary lymphedema after breast cancer with complete decongestive physiotherapy when the bandage is replaced with Kinesio Textape? - A pilot study. Physiother Theory Pract. 2016. 32(6), 446-451. doi: 10.3109/09593985.2016.1143541.
10. Meyer FP, Lisboa LF, Alves RCM, Avelino BM. Desenvolvimento e aplicação de um protocolo de avaliação fisioterapêutica em pacientes com Fibro Edema Gelóide. Fisioterapia em movimento. 2005. 1(18), 75-83. https://periodicos.pucpr.br/index.php/fisio/article/view/18552
11. Luebberding S, Krueger N, Sadick NS. Cellulite: An evidence-based review. Am J Clin
Dermatol. 2015. 16(4):243–56. doi: 10.1007/s40257-015-0129-5.
12. Sadick N. Treatment for cellulite. International Journal of Women's Dermatology. 2019. 5, 68–72. doi: 10.1016/j.ijwd.2018.09.002
13. Tunay VB, Akbayrak T, Bakar Y, Kayihan H, Ergun N. Effects of mechanical massage, manual lymphatic drainage, and connective tissue manipulation techniques on fat mass in women with cellulite. JEADV. 2010. 24, 138–142. doi: 10.1111/j.1468-3083.2009.03355.x
14. Schonvvetter B, Bagatin E, Soares MLJ. Avaliação longitudinal da drenagem linfática manual para o tratamento da lipodistrofia ginóide. Revista brasileira de dermatologia. 2014. 89(5),713-19. http://www.anaisdedermatologia.org.br/detalhe-artigo/102113/Avaliacao-longitudinal-da-drenagem-linfatica-manual-para-o-tratamento-da-lipodistrofia-ginoide-
15. Khan MH, Victor F, Rao B, Sadick NS. Treatment of cellulite. Part I Pathophysiology. J Am Acad Dermatol. 2010. 62, 361-70. doi: 10.1016/j.jaad.2009.10.042.
16. Delgado A, Rattes C, Abreu MES, Xavier MAO, Araújo DLQ, Silva RCB et al. Efeitos da Drenagem Linfática Manual na Diminuição do Edema de Membros Inferiores em Gestantes. Revista Pleiade. 2019. 13(28), 49-59. doi: 10.3 915/pleiade.v13i28.545
17. Freire de Oliveira MM, Costa Gurgel MS, Pace do Amaral MT, Amorim BJ, Ramos CD, Almeida Filho JG et al. Manual Lymphatic Drainage and Active Exercise Effects on Lymphatic Function Do Not Translate Into Morbidities in Women Who Underwent Breast Cancer Surgery. Arch Phys Med Rehabil. 2017. 98(2), 256-263. doi: 10.1016/j.apmr.2016.06.024.
18. Taradaj J, Halski T, Zduńczyk M, Rajfur J, Pasternok M, Chmielewska D, Piecha M, Kwaśna K, Skrzypulec-Plinta V. Evaluation of the effectiveness of Kinesio taping application in a patient with secondary lymphedema in breast câncer: a case repor. PrzMenopauzalny. 2014; 13(1): 73-77.
19. Tsai HJ, Hung HC, Yang JL, Huang CS, Tsauo JY. Could Kinesio tape replace the bandage in decongestive lymphatic therapy for breast-cancer-related lymphedema? A pilot study. Support Care Cancer. 2009. 17(11),1353-60. https://doi.org/10.1007/s00520-009-0592-8
20. Tantawy SA, Abdelbasset WK, Nambi G, Kamel DM. Comparative Study Between the Effects of Kinesio Taping and Pressure Garment on Secondary Upper Extremity Lymphedema and Quality of Life Following Mastectomy: A Randomized Controlled Trial. Integr Cancer Ther. 2019. 18, 1-10. doi: 10.1177/1534735419847276
21. Gatt M, Willis S, Leuschner S. A meta-analysis of the effectiveness and safety of kinesiology taping in the management of cancer-related lymphoedema. Eur J Cancer Care (Engl). 2017. 26(5), 1-15. doi: 10.1111/ecc.12510
22. Friedmann DP, Vick GL, Mishra V. Cellulite: a review with a focus on subcision. Clin Cosmet Investig Dermatol. 2017. 10,17-23. doi: 10.2147/CCID.S95830
23. Karwacińska J, Kiebzak W, Stepanek-Finda B, Kowalski IM, Protasiewicz-Fałdowska H, Trybulski R et al. Effectiveness of Kinesio Taping on hypertrophic scars, keloids and scar contractures. Polish Annals of Medicine. 2012. 19(1), 50-57. https://doi.org/10.1016/j.poamed.2012.04.010
24. Machado PFA, Pezzolo AC, Farcic ST, Tacani MP, Tacani ER, Liebano ER. Effects of Manual Lymphatic Drainage in pregnancy: review of the literature. Ter Man. 2012. 10(48), 1-5. http://institutopro.com.br/wp-content/uploads/2017/10/dlm-farcic.pdf
25. Pérez Atamoros FM, Alcalá Pérez D, Asz Sigall D, Ávila Romay AA, Barba Gastelum JA, de la Peña Salcedo JÁ et al. Evidence-based treatment for gynoid lipodystrophy: A review of the recent literature. J Cosmet Dermatol. 2018. (6), 977-983. doi: 10.1111/jocd.12555