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An Enhanced Self-Care Protocol for People Affected by Moderate to Severe Lymphedema

Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
Author to whom correspondence should be addressed.
Methods Protoc. 2019, 2(3), 77;
Received: 28 June 2019 / Revised: 22 August 2019 / Accepted: 1 September 2019 / Published: 4 September 2019
Lymphedema is a chronic skin disease that has many causes and leads to significant disfigurement and disability worldwide. Recommendations for lymphedema self-care vary by setting and the World Health Organization guidelines for people affected by lymphatic filariasis- and podoconiosis-related lymphedema are centered around a basic daily hygiene regimen. Research on cancer-related lymphedema in developed country settings suggests that deep-breathing exercises and self-massage can improve lymphedema status, but these exercises are not routinely taught to people affected by lymphedema in developing country settings. To determine if the activities proven in cancer-related lymphedema can improve outcomes for people affected by lymphatic filariasis- or podoconiosis-related lymphedema, an enhanced self-care protocol for lower limb lymphedema was developed and trialed in Nilphamari District in Bangladesh and Simada Woreda in Ethiopia. Enhanced self-care activities were chosen on the basis that they would not add financial burden to patients or their families and included recommendations to perform deep-breathing exercises and self-massage, drink clean water, and eat fresh fruits and vegetables. The enhanced-care protocol was developed in collaboration with implementing partners in both countries and may be applicable in other populations affected by lower-limb lymphedema. Trial methods and results will be submitted for peer reviewed publication. Current recommendations for lymphedema self-care may be less effective for people with more advanced disease and new or cross-cutting methods are needed to improve outcomes for these populations. View Full-Text
Keywords: lymphedema; lymphatic-filariasis; podoconiosis; self-care; lower-limb; exercise; massage lymphedema; lymphatic-filariasis; podoconiosis; self-care; lower-limb; exercise; massage
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Douglass, J.; Mableson, H.E.; Martindale, S.; Kelly-Hope, L.A. An Enhanced Self-Care Protocol for People Affected by Moderate to Severe Lymphedema. Methods Protoc. 2019, 2, 77.

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