scholarly journals Fluid Shifts Induced by Physical Therapy in Lower Limb Lymphedema Patients

2020 ◽  
Vol 9 (11) ◽  
pp. 3678 ◽  
Author(s):  
Bianca Brix ◽  
Gert Apich ◽  
Andreas Roessler ◽  
Christian Ure ◽  
Karin Schmid-Zalaudek ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Plasma Volume ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Lymphatic Drainage ◽  
Whole Body ◽  
Fluid Composition ◽  
Manual Lymphatic Drainage ◽  
Complete Decongestive Therapy ◽  
Fluid Shifts

Complete decongestive therapy (CDT), a physical therapy including manual lymphatic drainage (MLD) and compression bandaging, is aimed at mobilizing fluid and reducing limb volume in lymphedema patients. Details of fluid shifts occurring in response to CDT are currently not well studied. Therefore, we investigated fluid shifts before, during and after CDT. Thirteen patients (3 males and 10 females, aged 57 ± 8.0 years, 167.2 ± 8.3 cm height, 91.0 ± 23.4 kg weight) diagnosed with stage II leg lymphedema participated. Leg volume, limb and whole-body fluid composition (total body water (limbTBW/%TBW), extracellular (limbECF/%ECF) and intracellular (limbICF/%ICF fluid), as well as ECF/ICF and limbECF/limbICF ratios were determined using perometry and bioelectrical impedance spectroscopy. Plasma volume, proteins, osmolality, oncotic pressure and electrolytes were assessed. Leg volume (p < 0.001), limbECF (p = 0.041), limbICF (p = 0.005) and limbECF/limbICF decreased over CDT. Total leg volume and limbTBW were correlated (r = 0.635). %TBW (p = 0.001) and %ECF (p = 0.007) decreased over time. The maximum effects were seen within one week of CDT. LimbICF (p = 0.017), %TBW (p = 0.009) and %ICF (p = 0.003) increased post-MLD, whereas ECF/ICF decreased due to MLD. Plasma volume increased by 1.5% post-MLD, as well as albumin and the albumin-to-globulin ratio (p = 0.005 and p = 0.049, respectively). Our results indicate that physical therapy leads to fluid shifts in lymphedema patients, with the greatest effects occurring within one week of therapy. Fluid shifts due to physical therapy were also reflected in increased plasma volume and plasma protein concentrations. Perometry, in contrast to bioelectrical impedance analysis, does not seem to be sensitive enough to detect small fluid changes caused by manual lymphatic drainage.

scholarly journals PHYSICAL THERAPY AFFECTS ENDOTHELIAL FUNCTION IN LYMPHEDEMA PATIENTS

Lymphology ◽  
2021 ◽  
Vol 53 (3) ◽  
Author(s):  
B Brix ◽  
G Apich ◽  
C Ure ◽  
A Roessler ◽  
N Goswami
Keyword(s):  
Physical Therapy ◽  
Endothelial Function ◽  
Vascular Function ◽  
Lymphatic Drainage ◽  
Manual Lymphatic Drainage ◽  
Beneficial Effects ◽  
Compression Bandaging ◽  
Complete Decongestive Therapy ◽  
Plasma Adma ◽  
Retinal Microvasculature

Lymphedema arises due to a malfunction of the lymphatic system and can lead to massive tissue swelling. Complete decongestive therapy (CDT), consisting of manual lymphatic drainage (MLD) and compression bandaging, is aimed at mobilizing fluid and reducing volume in affected extremities. Lymphatic dysfunction has previously been associated with chronic inflammation processes. We investigated plasma ADMA as an indicator of endothelial function/inflammation before-, during- and after-CDT. Also assessed were vascular function parameters such as carotid-femoral pulse wave velocity (PWVcf), flow-mediated dilatation (FMD) and retinal microvasculature analysis. 13 patients (3 males and 10 females, 57 ± 8 years old (mean ± SD), 167.2 ± 8.3 cm height, 91.0 ± 23.5 kg weight), with lower limb lymphedema were included. Vascular function parameters were assessed on day 1, 2, 7, 14 and 21 of CDT, pre- and post-MLD. ADMA was significantly lower post-MLD (p=0.0064) and tended to reduce over three weeks of therapy (p=0.0506). PWVcf weakly correlated with FMD (r=0.361, p=0.010). PWVcf, FMD and retinal microvasculature analysis did not show changes due to physical therapy. The novel results from this study indicate that lymphedema does not affect endothelial function and lymphedema patients may therefore not have a higher risk of cardiovascular diseases. Our results further suggest that manual lymphatic drainage with or without full CDT could have potentially beneficial effects on endothelial function in lymphedema patients (by reducing ADMA levels), which has not been reported previously.

scholarly journals Changes in Indocyanine Green Lymphography Patterns after Physical Treatment in Secondary Upper Limb Lymphedema

2020 ◽  
Vol 9 (2) ◽  
pp. 306
Author(s):  
María Elena Medina-Rodríguez ◽  
María de-la-Casa-Almeida ◽  
Jesús González Martín ◽  
María Hermida Anllo ◽  
Esther M. Medrano-Sánchez
Keyword(s):  
Breast Cancer ◽  
Physical Therapy ◽  
Indocyanine Green ◽  
Upper Limb ◽  
Lymphatic Drainage ◽  
Manual Lymphatic Drainage ◽  
Physical Treatment ◽  
Lymphatic Function ◽  
Disease Patterns ◽  
Before And After

Indocyanine green (ICG) lymphography is used to evaluate the lymphatic function before and after pneumatic compression or post-manual lymphatic drainage. The aim of this study was to ascertain the changes in the fluoroscopic pattern produced by the provision of complex physical therapy. This prospective analytic (pretest-posttest) study was conducted in 19 patients with upper lymphedema secondary to breast cancer. Nine patients were excluded due to ICG found after 3 weeks. The ICG patterns were analyzed under basal conditions and after three weeks of treatment. After the treatment, 45% of the patients presented tracer remains in the affected limb, and this finding was significantly related to time of the lymphedema development. In one subject, the patterns remain unchanged or cannot be defined. Three of the ten patients observed present the worsening of at least 1 of the patterns and in the rest of the subjects, six cases, the improvement of the patterns is observed. In 60% of the cases, the most severe pattern reversed towards slight (splash) cases, and moderate cases reversed towards a slight case in 70% of cases. Therefore, after treatment with complex physical therapy, the pathological patterns observed in the pretest, which evolved positively, reverted their severity toward milder disease patterns or towards normality.

Whole-body Electromyostimulation plus Caloric Restriction in Metabolic Syndrome

2020 ◽  
Author(s):  
Alfonso Bellia ◽  
Bruno Ruscello ◽  
Rolando Bolognino ◽  
Gianluca Briotti ◽  
Paolo Roberto Gabrielli ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Caloric Restriction ◽  
Fat Mass ◽  
Systolic Pressure ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Whole Body ◽  
Middle Aged ◽  
The Metabolic Syndrome ◽  
Early Effects

AbstractWe investigated early effects of Whole-Body Electromyostimulation added to hypocaloric diet on metabolic syndrome features in sedentary middle-aged individuals. We randomly assigned 25 patients to Whole-Body Electromyostimulation plus caloric restriction or caloric restriction alone for 26 weeks. Anthropometrics, blood pressure, fasting glucose and insulin, HOMA-IR, glycated hemoglobin, lipids, uric acid, creatinphosphokynase, C-reactive protein were assessed. Body composition was evaluated with direct-segmental, multi-frequency Bioelectrical Impedance Analysis. Both groups lost approximately 10% of weight, with similar effects on waist circumference and fat mass. Change in free-fat mass was significantly different between groups (caloric restriction −1.5±0.2 vs. Whole-Body Electromyostimulation plus caloric restriction +1.1±0.4 kg, p=0.03). Whole-Body Electromyostimulation plus caloric restriction group experienced greater percent reductions in insulin (−45.5±4.4 vs. −28.2±3.6%, p=0.002), HOMA-IR (–51.3±3.2 vs. –25.1±1.8%, p=0.001), triglycerides (−22.5±2.9 vs. −4.1±1.6%, p=0.004) and triglycerides/HDL (p=0.028). Subjects trained with Whole-Body Electromyostimulation had also significant improvement in systolic pressure (138±4 vs. 126±7 mmHg, p=0.038). No discontinuations for adverse events occurred. In middle-aged sedentary subjects with the metabolic syndrome, Whole-Body Electromyostimulation with caloric restriction for 26 weeks can improve insulin-resistance and lipid profile compared to diet alone. Further studies are needed to ascertain long-term efficacy and feasibility of this approach in individuals with the metabolic syndrome.

scholarly journals Estimation of Acute Fluid Shifts Using Bioelectrical Impedance Analysis in Horses

2007 ◽  
Vol 21 (1) ◽  
pp. 176-183 ◽  
Author(s):  
C. Langdon Fielding ◽  
K. Gary Magdesian ◽  
Gary P. Carlson ◽  
Rebecca E. Ruby ◽  
Diane M. Rhodes
Keyword(s):  
Bioelectrical Impedance Analysis ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Fluid Shifts

Validity of segmental bioelectrical impedance analysis for estimating fat-free mass in children including overweight individuals

2017 ◽  
Vol 42 (2) ◽  
pp. 157-165 ◽  
Author(s):  
Megumi Ohta ◽  
Taishi Midorikawa ◽  
Yuki Hikihara ◽  
Yoshihisa Masuo ◽  
Shizuo Sakamoto ◽  
...  
Keyword(s):  
Bioelectrical Impedance Analysis ◽  
Cross Validation ◽  
Model Development ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Whole Body ◽  
Body Segments ◽  
Significant Difference ◽  
Development Group ◽  
Segmental Bioelectrical Impedance

This study examined the validity of segmental bioelectrical impedance (BI) analysis for predicting the fat-free masses (FFMs) of whole-body and body segments in children including overweight individuals. The FFM and impedance (Z) values of arms, trunk, legs, and whole body were determined using a dual-energy X-ray absorptiometry and segmental BI analyses, respectively, in 149 boys and girls aged 6 to 12 years, who were divided into model-development (n = 74), cross-validation (n = 35), and overweight (n = 40) groups. Simple regression analysis was applied to (length)2/Z (BI index) for each of the whole-body and 3 segments to develop the prediction equations of the measured FFM of the related body part. In the model-development group, the BI index of each of the 3 segments and whole body was significantly correlated to the measured FFM (R2 = 0.867–0.932, standard error of estimation = 0.18–1.44 kg (5.9%–8.7%)). There was no significant difference between the measured and predicted FFM values without systematic error. The application of each equation derived in the model-development group to the cross-validation and overweight groups did not produce significant differences between the measured and predicted FFM values and systematic errors, with an exception that the arm FFM in the overweight group was overestimated. Segmental bioelectrical impedance analysis is useful for predicting the FFM of each of whole-body and body segments in children including overweight individuals, although the application for estimating arm FFM in overweight individuals requires a certain modification.

scholarly journals Investigation of Body Development in Growing Holstein Heifers With Special Emphasis on Body Fat Development Using Bioelectrical Impedance Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Kathrin Heine ◽  
Viktoria Kichmann ◽  
Miriam K. von Kuhlberg ◽  
Ingrid Vervuert ◽  
Lisa Bachmann ◽  
...  
Keyword(s):  
Body Fat ◽  
Body Condition ◽  
Bioelectrical Impedance Analysis ◽  
Skeletal Development ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
The Body ◽  
Skeletal Growth ◽  
Whole Body ◽  
Fat Tissue

This study analyzed skeletal development, body condition, and total body fat development of growing heifers. A total of 144 female primiparous Holstein cattle from four commercial dairy farms with different degrees of stillbirth rates were examined during the rearing period. This included measurements in body condition, fat tissue, metabolic, and endocrine factors. Pelvic measurements and the sacrum height were analyzed to assess skeletal development. The body condition was classified via body condition scoring, bioelectrical impedance analysis (BIA), back fat thickness measurements, and the body mass. For the first time, BIA was used as an appropriate method to evaluate the fat tissue content of cattle throughout the rearing period. This analysis technique can be performed on heifers aged 8–15 months. Throughout that period, the fat content decreased while the skeletal development increased. In addition, high free fatty acid concentrations in serum of the animals with high frame development were found, supporting our hypothesis that stored energy of body fat deposits is used for skeletal growth. Furthermore, we were able to demonstrate complex endocrine relationships between fat metabolism and skeletal growth by using specific markers, such as leptin, insulin growth factor-1 (IGF-1), and estradiol (E2). Food analysis showed high crude protein (CP) levels in the total mixed ration above recommendation for daily protein intake of all farms. However, there was a positive correlation between CP and the body frame measurements in our study. In summary, we established a novel regression formula for BIA analysis (“BIA-Heine”) in heifers to evaluate the body composition throughout different ages and physiological stages in the development of heifers. This special formula allows the evaluation of fat tissue without a whole-body analysis and therefore provides an innovative technique for animal welfare support.

Bioelectrical Impedance and Hemodialysis

1995 ◽  
Vol 18 (11) ◽  
pp. 700-704 ◽  
Author(s):  
S. Mandolfo ◽  
M. Farina ◽  
E. Imbasciati
Keyword(s):  
Body Fluid ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Distribution Volume ◽  
Fluid Composition ◽  
Dialysis Session ◽  
Weight Losses ◽  
Before And After ◽  
Fluid Compartments ◽  
Urea Distribution Volume

Bioimpedance is a simple and non-invasive method of assessing body fluid composition. The aim of our study was to evaluate the reliability of impedance: a) to measure urea distribution volume considered to be coextensive with total body water (TBW); b) to assess the changes in body fluid compartments before and after dialysis; c) to predict hypotensive episodes. In twelve hemodialysis patients, TBW measured by bioelectrical impedance analysis (BIA) before a dialysis session was significantly correlated with the urea distribution volume estimated by dialysis direct quantification (r=0.64, p < 0.05) and with TBW calculated by the Watson equation (r=0.65, p < 0.05). Anthropometric values were, on average, 4.8% higher. TBW measured by BIA at the end of treatment overestimated fluid losses induced by ultrafiltration by 14% to 70%, while TBW 6 h after dialysis reflected the weight losses. On line BIA during hemodialysis has a very low positive predictive value (41.6%) and poor sensitivity (66%) for the prediction of hypotension. In conclusion, BIA is helpful in assessing the urea distribution volume but is not reliable for assessing acute fluid changes nor for predicting hypotensive episodes related to hemodialysis.

Sign in / Sign up

Export Citation Format

Share Document