Next Article in Journal
Models Contribution to the Understanding of Sarcoidosis Pathogenesis: “Are There Good Models of Sarcoidosis?”
Next Article in Special Issue
The Active with OsteoArthritis (AktivA) Physiotherapy Implementation Model: A Patient Education, Supervised Exercise and Self-Management Program for Patients with Mild to Moderate Osteoarthritis of the Knee or Hip Joint. A National Register Study with a Two-Year Follow-Up
Previous Article in Journal
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Efficacy of Repeat Immunoadsorption
Previous Article in Special Issue
A Multidisciplinary Approach for Improving Quality of Life and Self-Management in Diabetic Kidney Disease: A Crossover Study
Article

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

1
Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
2
Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 3BX, UK
3
Filariasis Elimination and STH Control Program, Ministry of Health and Family Welfare, Dhaka 1000, Bangladesh
4
Centre for Injury Prevention and Research Bangladesh, Dhaka 1206, Bangladesh
5
College of Medicine and Public Health, Flinders University, Bedford Park SA 5042, Australia
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(8), 2444; https://doi.org/10.3390/jcm9082444
Received: 18 June 2020 / Revised: 26 July 2020 / Accepted: 28 July 2020 / Published: 30 July 2020
(This article belongs to the Special Issue Self-Management and Health Promotion in Chronic Disease)
Background: 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. Methods: 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. Results: 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), p < 0.001). Conclusion: 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. View Full-Text
Keywords: lymphedema; lymphatic filariasis; self-care; tissue tonometry; lower extremity; massage; breathing lymphedema; lymphatic filariasis; self-care; tissue tonometry; lower extremity; massage; breathing
Show Figures

Figure 1

MDPI and ACS Style

Douglass, J.; Mableson, H.; Martindale, S.; Jhara, S.T.; Karim, M.J.; Rahman, M.M.; Kawsar, A.A.; Khair, A.; Mahmood, A.S.; Rahman, A.F.; Chowdhury, S.M.; Kim, S.; Betts, H.; Taylor, M.; Kelly-Hope, L. 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. J. Clin. Med. 2020, 9, 2444. https://doi.org/10.3390/jcm9082444

AMA Style

Douglass J, Mableson H, Martindale S, Jhara ST, Karim MJ, Rahman MM, Kawsar AA, Khair A, Mahmood AS, Rahman AF, Chowdhury SM, Kim S, Betts H, Taylor M, Kelly-Hope L. 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. 2020; 9(8):2444. https://doi.org/10.3390/jcm9082444

Chicago/Turabian Style

Douglass, Janet, Hayley Mableson, Sarah Martindale, Sanya T. Jhara, Mohammad J. Karim, Muhammad M. Rahman, Abdullah A. Kawsar, Abul Khair, ASM S. Mahmood, AKM F. Rahman, Salim M. Chowdhury, Susan Kim, Hannah Betts, Mark Taylor, and Louise Kelly-Hope. 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, no. 8: 2444. https://doi.org/10.3390/jcm9082444

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop