@article{94937,
  keywords = {Lymphedema},
  author = {Douglass J and Hailekiros F and Martindale S and Mableson H and Seife F and Bishaw T and Nigussie M and Meribo K and Tamiru M and Agidew G and Kim S and Betts H and Taylor M and Kelly-Hope L},
  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},
  abstract = {<jats:p>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.</jats:p>},
  year = {2020},
  journal = {Journal of Clinical Medicine},
  volume = {9},
  pages = {4077},
  publisher = {MDPI AG},
  issn = {2077-0383},
  url = {https://www.mdpi.com/2077-0383/9/12/4077/pdf},
  doi = {10.3390/jcm9124077},
  language = {eng},
}