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Effect of physiotherapy treatment on primary and secondary lymphedema
OBOŘILOVÁ, Vendula
This bachelor thesis discusses the treatment options for lymphoedema and the influence of individual regimens on the treatment of this disease. I have divided the theoretical part into four chapters. In the first chapter I explain the anatomy of the lymphatic system, the second chapter describes its physiological function and then its pathology. The third chapter is devoted to lymphoedema, I explain the principle of the different types of lymphoedema, how to prevent them, how to diagnose them and what complications can occur. The last chapter of the theoretical part discusses in detail the methods of treatment, the essential method is manual and instrumental lymphatic drainage, then I discuss bandaging, physical exercise, breathing excercises, selected types of physical therapy and last but not least I mention skin care, pharmacotherapy and spa treatment. The practical part of the research was carried out in the form of qualitative research. I worked with 4 patients, two of them are treated with primary lymphedema and two with secondary lymphedema. The patients practiced every day an agreed exercise unit, which was uniform for all of them, at the same time, based on the doctor's recommendation, they attended manual and instrumental lymphatic drainage at the outpatient clinic, while following the regimen, in which there were minor nuances for each patient. I evaluated the results by means of an entrance and exit kinesiological analysis, in which somatometry and goniometry played a major role, an entrance and exit interview and a comparison of photographs. I compared the objective results according to the results of somatometry and goniometry, where there was an improvement in reduction of swelling and increase in range of motion in 3 out of 4 cases. Subjective evaluation was provided by the patients based on semi-structured interviews, which I used to find out what lifestyle change the patients found most influential. Here the results were quite different, with the primary lymphoedema patient reporting feeling the greatest improvement after showering with cold water, and the secondary lymphoedema being most affected by bandages and regular exercise.
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Influence of physiotherapy and regimen recommendations on lymphedema therapy
KRÁTOŠKOVÁ, Kristýna
This bachelor thesis deals with the issue of lymphedema and the effect of physiotherapy and regimen recommendations on this type of swelling. In the theoretical part of my bachelor thesis, I describe in the anatomy of the lymphatic system in the first chapter. The second chapter describes the lymphedema, its classification, clinical picture, diagnostic methods and complications of lymphedema that may occur. Lymphedema therapy and regimen recommendations are also a very important subchapter. I elaborated the practical part in the form of qualitative research and subsequnet creation of case studies. I selected four patients with lymphedema, whom I monitored lower limb circumferences in connection with regimen recommendations and physiotherapy. These data were compared with the subjective feelings of patients and subsequently the research was evaluated. The main aim of this bachelor thesis was to present possible regimen recommendations in treatmen of lymphedema and to evaluate their influence on the course of edema. Research shows that even partial adherence to the proposed recommendations has the effect of reducing limb swelling.
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Therapeutic importance of manual lymphatic drainage for lymphedema of limbs
VOTRUBOVÁ, Eva
The importance of lymphatic drainage and other techniques used to cure lymphedema was known as early as around the year 3,000 BC. In the Czech Republic it became quite common after 1992, when the Czech Society of Lymphology was founded. Since the number of professionals in this area has been increasing and so has the number of patients, which makes the cure of lymphedema a very topical question. The first chapter of the theoretical part of my thesis is devoted to the history of the anatomy of lymphatic system, lymphedema and manual lymphatic drainage. There are also chapters on the definition of lymphedema and its classification according the mechanism of its creation and pathophysiology which triggers this problem. The differences between primary and secondary lymphedema are described in detail. I also sum up the knowledge about the etiology of lymphedema, its clinical picture, its differential diagnosis and stages of development. Apart from surgical, pharmacological and spa treatment I deal with decongestive treatment, which includes instrumental lymphatic drainage, banding, regime measurements, special exercise and manual lymphatic drainage. The chapter on manual lymphatic drainage deals both with effect and indications and contraindications of this method. The basic aim of my thesis is to map the contribution of manual lymphatic drainage to the cure of the lymphedema of limbs with special attention to the span of motion of joints and circumference of the limb before and after the therapy. The method of quantitative research was used for the practical part. The research was done on 3 respondents, who went through the entry examination. It contained the taking of thorough anamnesis including the personal data and family, social, professional etc. anamnesis. I also did a kinesiology analysis, which contained the aspection from the front, from the side and from the back and the values which were of the highest importance to me: circumference of the limbs and goniometric measuring of the span of motion of joints of the afflicted limb in comparison to the healthy one. The first research question is: What is the influence of the manual lymphatic drainage on circumference of the afflicted limb? The second question is: What is the influence of the manual lymphatic drainage on the span of motion of joints of the afflicted limb? During my internship in the rehabilitation centre in Borovany I had consultations with Jana Poláková, BA, who is a graduate of a certified course of manual lymphatic drainage. We discussed the choice of suitable patients, possible therapy and short-term and long-term plans. After every first or second massage I conducted a check measurement with all probands. Al in all conducted 5 measurements with each proband. The aim of my thesis was to map the contribution of the lymphatic drainage to the rehabilitation and its positive influence on the overall improvement of the patient´s health. The research was conducted in the rehabilitation centre in Borovany through an interview, retrospective data analysis, measurements of the circumference of the limbs and the span of motion of joints and observation and examining of the afflicted limbs. Subjectively all the patients find manual lymphatic drainage useful in the treatment of lymphedema. They mention improvements in the visible decrease in circumference of the limbs and the span of motion of joints as well as the overall perception of the limbs, their posture and motoric. Objectively the decrease of centimetres in circumference of the limbs and increase in the span of motion of joints was observed with all the patients.
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The use of lymph drainage in patients with lymphedema
DĚKANOVÁ, Klára
For my bachelor thesis I chose the theme ?Utilisation of the lymph drainage at patients with lymphedema?. In the Czech Republic the lymph drainage is a relatively new method which is used in medical facilities only since the year 1992. Efforts to introduce this method in the area of the Czech Republic came already before, since the seventies of the 20th century this problems was dealt by MUDr. Miroslav Bechyně CSc. Thanks to him in 1992 the first course of manual lymph drainage was realised in the Czech Republic. In the same year MUDr. Bechyně contributed to the foundation of the League against swelling and he made a motion to the birth of the Czech society of lymphology. The aim of my thesis was to acquaint patients with the possibilities of the use of the lymph drainage in the health care, to find out to which extent it is possible to influence the lymphedema and above all how this method affects the global state of patients. In the theoretical part of the bachelor thesis I summarized the findings dealing with this problems. I engaged myself in the history of lymph drainage and in the research of the lymph system in the world and in our country. In my thesis I defined the notion of lymphedema and I sorted it according to its origin into primary and secondary. Next in the thesis I present the diagnosis of lymphedema and the possibilities of his conservative and chirurgical treatment. Among possibilities how to treat the lymphedema I chose in particular manual and instrumental lymph drainage. I present also indications and contraindications of the lymph drainages. In the thesis I dealt as well with the use of lymph taping. This method is more and more popular at patients with the chronical lymphedema. The application of the lymph tape has many advantages, for example it does not limit patients in move. In the last chapter of the theoretical part I dealt with possibilities of the spa treatment at patients with lymphedema. The practical part of my thesis was realised by the qualitative research strategy and the results were treated by the form of case interpretations. The research sample was constituted by four probands who had the diagnosis of lymphedema and whose therapy took place in the rehabilitation department of the health centre Poliklinika Jih MEDIPONT s.r.o. in České Budějovice. The sample was chosen from clients with various kinds of lymphedema who were willing to cooperate on my bachelor thesis. The chosen sample was constituted by one client with primary lymphedema and three clients with secondary lymphedema. Clients with the secondary lymphedema had diagnoses venous insufficiency, postoperative and post-traumatic lymphedema. All probands underwent 10 therapies of the manual and instrumental lymph drainage. At the beginning and at the end of the therapy the lower limb circumferences were measured. With the patient´s consent I have used their health documentation, I have elaborated their detailed anamnesis and I have realised a structured dialogue with all probands. The dialogue contained both closed-ended and open-ended questions in order to chart proband´s health state and the contribution of the implemented therapy. After the end of the therapy the probands had possibility to express their subjective opinions on the undergone treatment. All probands found out lymph drainage as a very pleasant procedure. Three of four probands have noticed improvement of their health state and a visible swelling reduction. At the fourth patient, who was treated with the lymphedema caused by the venous insufficiency the improvement did not take place yet. But this patient says that she did not observe regime measures. The doctor proposed to the patient to continue with the treatment. The results of my bachelor thesis may be used by other physiotherapists for the needs of education or for a further research.
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The importance of lymphatic drainage in physiotherapy
VINKLEROVÁ, Miroslava
The theoretical part summarizes all the theoretical knowledge on the topic. I am presenting a brief history of the discovery of the lymphatic vessels and the lymphatic drainage, the lymphatic system anatomy and its functions in the human body. Next, I have defined the concept of lymphoedema and divided it by its origin to primary and secondary lymphedema. The work includes the diagnosis of lymphedema , both conservative and surgical treatment options, indications and contraindications of lymphatic drainage and the regime remedies to patients with lymphedema, where I have stated which activities patients should avoid. The conservative treatment consist of four pillars, i.e. a manual lymphatic drainage, an instrument lymphatic drainage, compression bandaging and decongestion exercise. One chapter covers the rehabilitation after a breast surgery with possible postoperative incidence of lymphedema, autolymphatic drainage and the metod of lymph ? taping, which has become popular with both lymphoterapists and even the patients themselves. The practical part has been conducted as a qualitative research strategy and its results were processed in a form of case studies. The research test group consisted of five patients with clinically proven lymphedema. Two patients had postoperative lymphedema and three of them posttraumatic one. The aim was to explore the benefits of lymphatic drainage in rehabilitation and its positive impact on improving the patient´s general state of health. The research conducted at the outpatient department of Polyclinic Jih MEDIPONT Ltd in České Budějovice using a structured interview, a retrospective analysis of data and observations. All patients agree on the benefits of lymphatic drainage therapy and after passing through the lymph drainage techniques their general states of health have improved.
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