Rogério Eduardo Tacani

Retrospective study of the physical therapy modalities applied in head and neck l ymphedema treatment.

Secondary lymphedema after head and neck cancer treatment is a serious complication and its management can be a challenge. The purpose of this study was to verify which physical therapy modalities were applied in the treatment of head and neck lymphedema through a retrospective analysis.

Characterization of symptoms and edema distribution in premenstrual syndrome

Background Premenstrual syndrome is a group of symptoms linked to the menstrual cycle, and edema is among these symptoms. Physiotherapy is often sought by many patients for the treatment of edema; however, for an adequate prescription of physiotherapeutic procedures, the distribution of edema throughout the body has yet to be characterized. Objective To determine the most frequent symptoms and body regions that present with edema in women during the premenstrual period. Subjects and methods Sixty women with a mean age of 24.6±4.7 years were evaluated during their premenstrual (between days 21 and 28) and menstrual period (between days 1 and 3), and the collected data included body mass, height, biotype (body-fat distribution), face, breast, limb-circumference measurements, and limb-volume estimate, and an adapted version of the Premenstrual Symptoms Screening Tool was used. Statistical analysis was performed using Student’s t-test and the test for equality of two proportions (P≤0.05). Results Premenstrual syndrome was identified in 91.7% of the women, and the most frequent symptoms were irritability (73.33%) and physical symptoms, including swelling (65%), and anxiety (58.3%). Edema was detected in the following areas: facial, epigastric, mammary, umbilical, and pubic, the mid-third of the arms, distal forearm, in both thighs and in the mid-third of the legs determined by circumference measurements, and in both upper and lower limbs, according to the estimated volume. Conclusion In this study population, the most frequent symptoms were irritability, physical symptoms, and anxiety, with distribution of edema in the face, breast, abdomen, pubic area, distal upper limb, and proximal lower limb.

Intervenção fisioterapêutica nas sequelas de drenagem linfática manual iatrogênica: relato de caso

Recently, the manual lymphatic drainage (MLD) is an important resource in the treatment of edemas, lymphedemas, and other unaesthetic conditions. However, problems caused by the incorrect application of this therapy have been observed in the clinical practice. The aims of this case report were to describe sequelae resulting from the negligent application of MLD on a young patient, and to determine the effects of physical therapy on the treatment of sequelae. A 27-year-old Caucasian woman presented with a large ecchymosis (28 x 9.5 cm) on the outer side of the left thigh, telangiectasias, micro varicose veins, and petechiae on the legs and thighs, intense pain, and edema, after undergoing an incorrect manual procedure for aesthetic purposes two days earlier. Physical therapy consisted of ultrasound application (3 MHz, pulsed mode, 20% duty cycle, SATP intensity of 0.4 W/cm²) to the ecchymosis site and MLD (Leduc method) for 20 minutes on the left thigh. The patient underwent nine physical therapy sessions until discharge from the hospital 16 days after injury. The effectiveness of physiotherapy intervention was verified in only some of the consequences caused by iatrogenic, without disregarding that the spontaneous remission of signs symptoms can have contributed to such fact. The study emphasizes the importance of awareness among physical therapists who work with this procedure to apply it appropriately in order to avoid such conditions.

Efeito da massagem clássica estética em adiposidades localizadas: estudo piloto

Devido ao padrao de beleza imposto atualmente, tem aumentado a procura por tratamentos esteticos como a massagem classica, porem sua suposta acao lipolitica ainda e uma questao controversa na literatura. O objetivo deste estudo foi verificar o efeito da massagem classica estetica nas adiposidades localizadas, por meio de perimetria do abdome, quadril e coxas e pela estimativa da espessura da tela subcutânea da parede abdominal (ETS) por ultrassonografia. Oito voluntarias (idade 33,9±8,9 anos, peso 65,1±8,4 kg) foram avaliadas quanto a MC, IMC e ETS 30 dias antes, logo antes do inicio da intervencao e apos esta. Foram efetuadas 12 sessoes de massagem classica estetica em coxas, gluteos e abdome por 30 minutos, tres vezes por semana. Foi encontrada reducao significativa apenas da perimetria na regiao do quadril (p=0,012), mas nao da ETS (p=0,301). A massagem classica estetica contribuiu apenas para a reducao da perimetria do quadril, e nao modificou outras medidas nem a espessura da tela subcutânea da regiao abdominal.

Drenagem linfática manual nos sintomas da síndrome pré-menstrual: estudo piloto

A sindrome pre-menstrual e um complexo de sintomas - dentre os quais o edema pre-menstrual - entre o 10o e o 14o dias que antecedem a menstruacao e cessam no inicio do fluxo menstrual. A tecnica de drenagem linfatica manual (DLM) drena o excesso de liquido acumulado, atua no edema e poderia aliviar esses sintomas. O objetivo deste estudo piloto foi verificar o efeito da DLM no alivio dos sintomas da sindrome pre-menstrual e a qualidade de vida relacionada a saude em quatro mulheres jovens. O estudo foi realizado ao longo de dois ciclos menstruais, ciclo 1 sem intervencao terapeutica, e o segundo ciclo, com aplicacao da tecnica de DLM. As participantes foram avaliadas, no inicio do ciclo 1 e final do ciclo 2, por anamnese, mensuracao de estatura e massa, estimativa da composicao corporal, diario de sintomas e quanto a qualidade de vida relacionada a saude, pelo WHOQoL-bref. Os resultados mostraram reducao significativa apenas do diâmetro de abdome superior nos niveis xifoide e umbilical; as medias total e individual dos sintomas do diario reduziram-se, porem sem significância, tal como ocorreu no aumento dos escores no WHOQoL-bref. A drenagem linfatica manual foi eficaz na diminuicao de um sintoma da sindrome pre-menstrual, o edema em regiao superior abdominal, e nao alterou a qualidade de vida dessas jovens.

Abordagem fisioterapêutica do linfedema bilateral de membros inferiores

INTRODUCTION: Lymphedema is the accumulation of protein interstitial fluid as a result of impaired lymphatic function, recommended the use of Complex Physical Therapy as a treatment. OBJECTIVE: To determine the effects of Complex Physical Therapy on the treatment and maintenance of bilateral lower limb lymphedema. METHODS: Seven patients, aged between 59 and 85 years, with bilateral lower limb lymphedema participated in this study. The study consisted of four periods: (1) Control period - first physiotherapeutic evaluation (the patients did not receive any treatment at this stage); (2) Treatment period (reduction stage) - second evaluation and physiotherapeutic treatment (complex physical therapy); (3) Maintenance period - third evaluation, patient discharge, and complex physical therapy; and (4) follow-up period - evaluation of the last stage. The time interval bewteen evaluations was 10-12 weeks. The leg volume was calculated using leg perimeter data and the formula for the volume of a truncated cone, and ankle swelling was measured using the figure-of-eight method. RESULTS: The mean ankle measurement and leg volume at the first, second, third and fourth evaluations were 62.32 cm and 6233 ml, 62.57 cm and 6308 ml, 56.75 cm and 5505 ml, and 57 cm and 5566 ml, respectively. Figure Eight measurements and leg volumes were significantly lower at the third and fourth evaluations than at the first and second evaluations (p < 0.001), showing a significant reduction in volume and stabilization of the lymphedema during the maintenace period. CONCLUSION: The complex physical therapy was efficient in the treatment and maintenance of bilateral lower limb lymphedema.

MASSA CORPORAL, IMAGEM CORPORAL E DESEJO POR TRATAMENTOS ESTÉTICOS NAS DIFERENTES FASES DO CICLO MENSTRUAL

Objective: analyze the body weight, body image and the desire for aesthetic treatments during the follicular and luteal phases of the menstrual cycle. Methods: this is a prospective longitudinal clinical trial, which forty women were followed for a complete menstrual cycle and evaluated by two times: Follicular Phase and Luteal Phase, for middle of the Body Shape Questionnaire (BSQ) and the Scale Figures Silhouettes and questioned about the desire for aesthetic treatments quantified by Visual Numeric Scale (VNS), during the months of january to may 2012, in the Physical Therapy of Sao Paulo City University. Results: there was an increase in body mass (p < 0.001) and the Scale Figures Silhouettes FF for FL (p = 0.058). Conclusions: increased body mass and impaired body image, however, there was no change in body image and the desire for aesthetic treatments in the different phases of the menstrual cycle.