title: Effects of physiotherapy combined with sirolimus in a patient with vascular malformation: A case report.
abstract: The aim of the present case report was to investigate the effects of a physiotherapy program combined with sirolimus in a child patient with upper extremity edema and joint limitation due to low-flow vascular malformation. This case report included an 11-year-old male patient (26 kg, 130 cm) diagnosed with congenital lymphovascular malformation on the left and right chest. The patient, who had edema on the upper left extremity and experienced joint limitations, was administered complete decongestive therapy (CDT) and manual therapy in combination with sirolimus. Physiotherapy included a total of 24 sessions, 3 sessions a week for 8 weeks. Following the physiotherapy, the patient was assigned to a home therapy program, and then the maintenance phase of the CDT was initiated. Evaluations were carried out at baseline, at the end of week 8, and after 12 months. Following the physiotherapy program combined with sirolimus, a decrease in extremity volume, an increase in joint movement range, and an improvement in disease-related complaints were observed. Physiotherapy methods combined with sirolimus may be an effective treatment method in patients with vascular malformations. However, further studies with larger sample size are warranted.
authors.affiliation: Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
authors.forename: Türkan
authors.initials: T
authors.lastname: Akbayrak
authors.affiliation: Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
authors.forename: Ceren
authors.initials: C
authors.lastname: Orhan
authors.affiliation: Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Baran
authors.affiliation: Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
authors.forename: Serap
authors.initials: S
authors.lastname: Kaya
authors.affiliation: Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
authors.forename: Gürsoy
authors.initials: G
authors.lastname: Coskun
authors.affiliation: Division of Pediatric Oncology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Varan
mesh_terms: D002648:Child; D003131:Combined Modality Therapy / Q000379:methods; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D026741:Physical Therapy Modalities; D020123:Sirolimus / Q000627:therapeutic use*; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000628:therapy*
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus
keywords: complete decongestive therapy; manual therapy; physiotherapy; sirolimus; vascular malformation