Effects of complex decongestive therapy and aquatic physiotherapy on markers of the inflammatory process in individuals with lymphedema

ABSTRACT

Background

Chronic lymphedema is a progressive and inflammatory disease caused by impaired lymphatic transport.

Purpose

This study evaluates the effects of complex decongestive therapy (CDT) and aquatic physiotherapy on markers of the inflammatory process and lower limb volumes in individuals with lymphedema.

Methods

A randomized controlled clinical trial was carried out with three groups: patients with lymphedema submitted to CDT, patients with lymphedema submitted to aquatic physiotherapy, and control group of individuals without lymphedema. The evaluation was performed through blood count, CRP measurements, C3, C4 complement, measurement of serum levels of cytokines interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), interleukins 4 (IL-4), 6 (IL-6), and 10 (IL-10), and the volume of a lower limb using the volume formula of a truncated cone. The study was registered with the Brazilian Clinical Trials Registry (RBR-4tpkszn).

Results

Our work showed a reduction in the TNF-α levels of patients in the CDT group (p = .028). Significant differences were found between the control group and the CDT group for IL-10 (p = .049) and Monocytes (p = .039). No significant reduction in limb volume was found.

Conclusion

Our results show that CDT was able to significantly reduce the inflammatory marker TNF-α in patients with lymphedema, suggesting an anti-inflammatory effect of the therapy.

KEYWORDS:

• Lymphedema
• complex decongestive therapy
• aquatic physiotherapy
• inflammation
• cytokines

Acknowledgments

This research was funded by Fundação para a Ciência e Tecnologia do Estado de Pernambuco (Foundation for Science and Technology of the State of Pernambuco – FACEPE), Brazil.

Disclosure statement

No potential conflict of interest was reported by the author(s).