title: Craniocervical manual lymphatic drainage and its impact on intracranial pressure - a pilot study.
abstract: Theoretical considerations and the results of animal studies indicate that manual lymphatic drainage (MLD) might have an impact on intracranial pressure (ICP). There is a lack of clinically qualitative investigations on patients with severe cerebral diseases.
  
  
  
  Between April 2013 and January 2015 a prospective observational study was performed on patients who were undergoing intracranial pressure measurement and treatment with MLD. ICP, cerebral perfusion pressure, mean arterial pressure (MAP), heart rate and oxygen saturation were recorded continuously 15 min before the procedure, during MLD (22 min) and for 15 min after the procedure. For analysis the data treatment units were divided into two groups: patients with a mean baseline ICP <15 mmHg (group 1) and patients with a mean ICP ≥15 mmHg before MLD (group 2).
  
  
  
  A total of 133 treatment units (61 patients) were analysed (group 1 n = 99; group 2 n = 34). The mean baseline ICP was 10.4 mmHg overall, and 8.3 mmHg and 18.6 mmHg respectively in group 1 and group 2; ICP significantly decreased during therapy with MLD and this persisted during the follow-up period in group 2. MAP did not show any significant differences between the different periods.
  
  
  
  Our data showed a significant reduction of ICP during therapy with craniocervical MLD in patients with severe cerebral diseases.
authors.affiliation: Department of Neurology, Klinikum Kassel, Kassel, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Roth
authors.affiliation: Department of Physiotherapy, Klinikum Kassel, Kassel, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Stitz
authors.affiliation: Department of Physiotherapy, Klinikum Kassel, Kassel, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Roth
authors.affiliation: Department of Neurology, Klinikum Kassel, Kassel, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Ferbert
authors.affiliation: Department of Neurosurgery, Klinikum Kassel, Kassel, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Deinsberger
authors.affiliation: Institute of Medical Biometry and Epidemiology (IMBE), Philipps University Marburg, Marburg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Pahl
authors.affiliation: Department of Hand, Plastic and Reconstructive Surgery, Klinikum Kassel, Kassel, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Engel
authors.affiliation: Department of Neurosurgery, Klinikum Kassel, Kassel, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Kleffmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain; D001927:Brain Diseases / Q000503:physiopathology / Q000628:therapy*; D000070642:Brain Injuries, Traumatic / Q000628:therapy; D001932:Brain Neoplasms / Q000628:therapy; D002574:Cervical Vertebrae; D005260:Female; D006801:Humans; D007427:Intracranial Pressure; D008208:Lymphatic System; D008297:Male; D000073297:Manual Lymphatic Drainage / Q000379:methods*; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: CPP; ICP; cerebral haemodynamics; manual lymphatic drainage; physiotherapy