Indian Journal of Physiotherapy & Occupational Therapy-An International Journal

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Different Therapeutic Responses to the Clinical Treatment of Elephantiasis


Affiliations
1 Livre Docente of the Cardiology and Cardiovascular Surgery Department of the Medicine School in São José do Rio Preto (FAMERP), Brazil: Professor of the Graduation and Post Graduation Courses of FAMERP, Brazil
2 Post Doctorate student of the Strictu Senso Post Graduation Course of the Medicine School in São José do Rio Preto and professor of the Lato-Sensu Post Graduation Course on Lymphovenous Rehabilitation of FAMERP, Brazil
     

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The objective of the present study is to report on different responses to intensive clinical treatment of elephantiasis. The cases of three patients who were submitted to intensive clinical treatment for elephantiasis of the lower limbs are reported. The patients were treated for weekly periods with intervals between to permit the skin to adapt to the new size. The first, a 24-year-old patient who had suffered from lymphedema since the age of 12 and presented with an initial leg circumference of 89 cm, was submitted to intensive treatment for six to eight hours per day for one week. In the first week the patient lost 20 cm in circumference and 10 kg in weight. In the following sessions, the losses were smaller, but continuous and varied according to the treatment. The second, a 42-year-old patient who had also suffered from lymphedema since the age of 12, had been submitted to surgeries that led to the development of intense fibrosis of the limb. For this patient the reductions were smaller, varying around 2 cm per month, even so the improvement was progressive. The third patient was 42 years old and had suffered from lymphedema since the age of 12 and presented with an initial leg circumference of 94 cm. In the first week the patient lost 20 cm in circumference and 12 kg in weight. In the following sessions, the losses were smaller, but continuous and varied according to the treatment. In conclusion, in the clinical treatment of elephantiasis, the therapeutic responses are different with fibrotic lymphoedema being more difficult to treat than fibroedematous lymphoedema.

Keywords

Elephantiasis, Lymphedema, Intensive Treatment, Evaluation
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  • Foldi M, Foldi E, Kubik S. Lymphostatic Disease. In Textbook of Lymphology for Physicians and Lymphedema Therapists Munich: Urban & Fischer, 2003.p.231.

  • Godoy JMP, Godoy MFG, Braile DM, Testoni B, Sanches RG. Dynamic evaluation of working pressures with gorgurão sleeves used in the treatment of lymphedema of the arm. Journal of Phlebology and Lymphology 2008; 1(1):5-7.

  • Casley-Smith JR, Boris M, Weindorf S, Lasinski B. Treatment for lymphedema of the arm—the Casley- Smith method: a noninvasive method produces continued reduction. Cancer. 1998 Dec 15;83(12 Suppl American):2843-60.

  • Ciucci1 JL, Krapp JC, Soracco JE, Ayaguavella J, Marcovecchio LD, Salvia C, et al.. Changes in clinical management and the evolution of an interdisciplinary therapeutic approach: 640 lymphedema patients over 20 years J Vasc Bras 2004;3(1):72-6.

  • Foldi M, Foldi E, Kubik S. Lymphostatic Disease. In Textbook of Lymphology. For Physicians and Lymphedema Therapists. Munich: Urban & Fischer, 2003 p.280.

  • Pereira de Godoy JM, Braile DM, de Fatima Guerreiro Godoy M. Lymph drainage in patients with joint immobility due to chronic ulcerated lesions. Phlebology. 2008; 23(1):32-4.

  • Godoy Godoy JMP, Godoy MFG. Lymphatic drainage. A new concept. J Vasc Br 2004; 3(1):77-80.

  • Godoy JMP, Braile DM, Godoy MFG. A Thirty-month Follow-up of the Use of a New Technique for Lymph Drainage in Six Patients. European Journal Vascular Endovascular Surgery 2002, 3: 91-3.

  • Godoy MFG, Godoy JMP, Braile DM. Desarrollo y evaluación de un aparato para el drenaje de edemas. Angiología 2006; 58(6):505-7.

  • Godoy JMP, Godoy MFG. New apparatus for mechanical lymph drainage in association of therapies in treatment of lymphoedema. Acta Phlebol 2005;6:125-8

  • Godoy JMP, Godoy MFG. Assessment of inelastic sleeves inpatients with upper limb lymphoedema. Indian Journal of Physiotherapy and Occupational Therapy 2007;1(4):3-5.

  • Thomas O’ Donnell. Principles of Medical and Physical Treatment. In Browse SN, Burnand KG, Mortimer OS Disease of the Lymphatics. London: Arnold, 2003. p.167.

  • Badger C, Seers K, Preston N, Mortimer P. Antibiotics / anti-inflammatories for reducing acute inflammatory episodes in lymphoedema of the limbs. Cochrane Database Syst Rev. 2004;(2):CD003143.

  • Godoy MFG. Activities of daily life in the treatment of lymphedema. Lymphology 2002/03; 35(Suppl 2): 213-5.

  • Godoy MFG, Godoy JMP, Braile DM. Pilot study with Myolymphokinetic activities in the treatment of lymphedema after breast cancer. Indian Journal of Physiotherapy and Occupational Therapy 2008; 2 (3):17-19.

  • McKenzie DC, Kalda AL. Effect of upper extremity exercise on secondary lymphedema in breast cancer patients: a pilot study. J Clin Oncol. 2003 Feb 1;21(3):463-6.

  • Ogawa Y, Hayashi K. 99mTc-DTPA-HSA lymphoscintigraphy in lymphedema of the lower extremities: diagnostic significance of dynamic study and muscular exercise. Kaku Igaku 1999;36(1):31-6.

  • McWayne J, Heiney SP. Psychological and social sequelae of secondary lymphedema. Cancer. 2005 Jun 20;104(3):457-466.

  • Pereira de Godoy JM, Braile DM, de Fátima Godoy M, Longo O Jr. Quality of life and peripheral lymphedema. Lymphology. 2002 Jun;35(2):72-5.

  • Artíbale MES, Godoy JMP, Godoy MFG, Braile DM. A new option for compression in the treatment of lymphedema in children. J Vasc Br 2005; 4(3):311-3. 21. Liu N. Metabolism of macromolecules in tissue. Lymphat Res Biol. 2003;1(1):67-70.

  • Liu NF, Zhang LR, Li SL, Cao WG, Zhang DS, Cao YL. Metabolism of hyaluronic acid and extremity lymphedema. Zhonghua Zheng Xing Wai Ke Za Zhi. 2004 Mar;20(2):113-6.


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  • Different Therapeutic Responses to the Clinical Treatment of Elephantiasis

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Authors

José Maria Pereira de Godoy
Livre Docente of the Cardiology and Cardiovascular Surgery Department of the Medicine School in São José do Rio Preto (FAMERP), Brazil: Professor of the Graduation and Post Graduation Courses of FAMERP, Brazil
Guerreiro Godoy Maria de Fátima
Post Doctorate student of the Strictu Senso Post Graduation Course of the Medicine School in São José do Rio Preto and professor of the Lato-Sensu Post Graduation Course on Lymphovenous Rehabilitation of FAMERP, Brazil

Abstract


The objective of the present study is to report on different responses to intensive clinical treatment of elephantiasis. The cases of three patients who were submitted to intensive clinical treatment for elephantiasis of the lower limbs are reported. The patients were treated for weekly periods with intervals between to permit the skin to adapt to the new size. The first, a 24-year-old patient who had suffered from lymphedema since the age of 12 and presented with an initial leg circumference of 89 cm, was submitted to intensive treatment for six to eight hours per day for one week. In the first week the patient lost 20 cm in circumference and 10 kg in weight. In the following sessions, the losses were smaller, but continuous and varied according to the treatment. The second, a 42-year-old patient who had also suffered from lymphedema since the age of 12, had been submitted to surgeries that led to the development of intense fibrosis of the limb. For this patient the reductions were smaller, varying around 2 cm per month, even so the improvement was progressive. The third patient was 42 years old and had suffered from lymphedema since the age of 12 and presented with an initial leg circumference of 94 cm. In the first week the patient lost 20 cm in circumference and 12 kg in weight. In the following sessions, the losses were smaller, but continuous and varied according to the treatment. In conclusion, in the clinical treatment of elephantiasis, the therapeutic responses are different with fibrotic lymphoedema being more difficult to treat than fibroedematous lymphoedema.

Keywords


Elephantiasis, Lymphedema, Intensive Treatment, Evaluation

References