Short-term Effect and Acceptability of Manual Lymphatic Drainage for Paediatric Limb Lymphoedema: A Prospective Study
Chakib El Habnouni, Valérie Tauveron, Sophie Leducq, Stéfania Gérémia, Pierre Allain, Hortense Touchard, Sophie-Anne Benejean, Laurent Machet, Annabel Maruani
Paediatric lymphoedema (LE) is a rare condition, for which there is little data available regarding treatments. The aim of this study was to assess the short-term effect and acceptability of a 30-min session of manual lymphatic drainage (MLD) in children with well-documented LE of the lower limbs. Fifteen children were included (8 males; median age 11 years). Comparison of the sum of circumference values for the whole limb before and after MLD revealed a slight, but significant, reduction (from a median of 289.8 to 285.5 cm, p = 0.024), but the limb volumes did not decrease significantly (from a median of 4,870.3 to 4,772.3 ml, p = 0.394). Dermal thickness, measured by high-resolution ultrasound, decreased from 1.44 to 1.40 mm (p < 0.001). All children reported improvement in well-being, and found MLD useful. In conclusion, MLD is well accepted by children, but has poor impact on LE swelling. However, it decreases cutaneous oedema by mobilizing the lymph fluid.
This study evaluated the immediate effect and acceptability of a single session of manual lymphatic drainage for paediatric limb lymphoedema. For each child the circumference of the affected limb was measured at many points, and the volume calculated. Skin thickness was measured with ultrasound. These measurements were made before and after the treatment. After the massage the children completed a questionnaire to evaluate the usefulness and acceptability of this treatment. Our results showed that this treatment had a slight, but significant, effect on skin thickness. Nevertheless, the limb volume reduction was not significant.