title: Influence of manual lymphatic drainage on health-related quality of life and symptoms of chronic venous insufficiency: a randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the efficacy of manual lymphatic drainage (MLD) in improving health-related quality of life (HRQOL), symptomatology, and physical status in patients with chronic venous insufficiency (CVI).
  
  
  METHODS
  Single-blind randomized controlled trial.
  
  
  METHODS
  Health community attendant service.
  
  
  METHODS
  Subjects with CVI (N=41) were randomly assigned to an experimental group (n=20; mean age, 54.6±11.3y) or control group (n=21; mean age, 46.8±11.1y).
  
  
  METHODS
  The experimental group completed 10 lower extremity MLD sessions over 4 weeks and 1 educational session. The control group only attended the educational session. Outcome measures were taken at baseline (t0), at the end of 4 weeks (t1), and after 2 months for follow-up (t2).
  
  
  METHODS
  HRQOL was assessed with the Chronic Venous Insufficiency Quality of Life Questionnaire-20, symptoms (fatigue, heaviness) were assessed with a visual analog scale, severity of the disease was assessed with the Venous Clinical Severity Score (VCSS) (total score, score for each item), leg volumetry was assessed with perimeters, and plantar/dorsiflexion strength and ankle range of motion (ROM) were assessed with dynamometry.
  
  
  RESULTS
  A significant interaction group×time effect was found for pain on HRQOL (F2,78=3.507; P=.035; partial η2=.087), clinical severity (F2,78=5.231; P=.007; partial η2=.118), especially for venous edema (assessed with the VCSS), fatigue (F1.67,65.21=4.690; P=.012; partial η2=.107), and heaviness (F1.57,61.32=9.702; P=.001; partial η2=.199), with the experimental group improving from t0 to t1 and t0 to t2 in all of these outcomes. No effect of MLD treatment could be found for ankle muscle strength, ankle ROM, and leg volume.
  
  
  CONCLUSIONS
  Short-term MLD treatment ameliorates CVI severity and related edema, symptoms, and pain HRQOL in patients with CVI.
authors.affiliation: Laboratório de Biomecânica e Morfologia Funcional, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Lisboa, Portugal; Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Lisboa, Portugal; Instituto Politécnico de Castelo Branco, Escola Superior de Saúde Dr. Lopes Dias, Castelo Branco, Portugal. Electronic address: crisostomo.rute@ipcb.pt.
authors.forename: Rute Sofia
authors.initials: RS
authors.lastname: dos Santos Crisóstomo
authors.affiliation: Instituto Politécnico de Castelo Branco, Escola Superior de Saúde Dr. Lopes Dias, Castelo Branco, Portugal; Clinica Médico-Cirúrgica das Violetas, Castelo Branco, Portugal.
authors.forename: Daniela Sofia Albino
authors.initials: DS
authors.lastname: Costa
authors.affiliation: Instituto Politécnico de Castelo Branco, Escola Superior de Saúde Dr. Lopes Dias, Castelo Branco, Portugal.
authors.forename: Catarina
authors.initials: C
authors.lastname: de Luz Belo Martins
authors.affiliation: Instituto Politécnico de Castelo Branco, Escola Superior de Saúde Dr. Lopes Dias, Castelo Branco, Portugal.
authors.forename: Tânia Isabel Russo
authors.initials: TI
authors.lastname: Fernandes
authors.affiliation: Laboratório de Biomecânica e Morfologia Funcional, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Lisboa, Portugal; Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Lisboa, Portugal.
authors.forename: Paulo A
authors.initials: PA
authors.lastname: Armada-da-Silva
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000503:physiopathology; D002908:Chronic Disease; D004322:Drainage / Q000379:methods*; D005260:Female; D006304:Health Status; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008209:Lymphedema / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008405:Massage; D008875:Middle Aged; D053580:Muscle Strength; D009929:Organ Size; D010146:Pain / Q000209:etiology; D011788:Quality of Life; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013997:Time Factors; D014689:Venous Insufficiency / Q000150:complications / Q000503:physiopathology / Q000628:therapy*
keywords: Edema; Manual therapies; Rehabilitation; Venous insufficiency