title: Effect of manual lymph drainage after hindfoot operations.
abstract: OBJECTIVE
  Manual lymph drainage therapy is often prescribed following hindfoot operations. However, the relative efficacy of this treatment component has not yet been determined.
  
  
  METHODS
  A two-group pre-test-post-test study design was used in this preliminary randomized clinical trial of 23 subjects who underwent hindfoot surgery. Patients were randomly assigned into two groups: an intervention group of 11 patients who received standard physiotherapy plus manual lymph drainage; and a control group of 12 patients who received standard physiotherapy but no lymph drainage. The main outcome measure was the percentage reduction in excess limb volume, measured by the water displacement method at the second post-operative day (t1) and at the day of discharge (t2).
  
  
  RESULTS
  Compared to the control group, a significant reduction in post-operative swelling was measured in the intervention group only (p = 0.011).
  
  
  CONCLUSIONS
  Application of lymph drainage techniques after hindfoot operations, in combination with standard physiotherapy exercises, achieves greater limb volume reduction than exercise alone. The present study offers an insight into a treatment that may shorten rehabilitation and thereby control the cost of caring for post-operative treatment complicated by post-operative swelling.
authors.affiliation: Department of Physical Therapy, University of Zurich, Balgrist, Switzerland. johnny.kessler@balgrist.ch
authors.forename: Thomas
authors.initials: T
authors.lastname: Kessler
authors.forename: Eling
authors.initials: E
authors.lastname: de Bruin
authors.forename: Florian
authors.initials: F
authors.lastname: Brunner
authors.forename: Patrick
authors.initials: P
authors.lastname: Vienne
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kissling
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000601:surgery*; D001178:Arthroplasty / Q000534:rehabilitation*; D019643:Arthroplasty, Replacement / Q000534:rehabilitation; D004322:Drainage; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011184:Postoperative Period