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Effect of manual lymph drainage after hindfoot operations
Kessler T, de Bruin E, Brunner F, Vienne P, Kissling R
Physiotherapy Research International 2003;8(2):101-110
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND AND PURPOSE: Manual lymph drainage therapy is often prescribed following hindfoot operations. However, the relative efficacy of this treatment component has not yet been determined. METHOD: A two-group pre-test-post-test study design was used in this preliminary randomized clinical trial of 23 subjects who underwent hindfoot surgery. Patients were randomly assigned into two groups: an intervention group of 11 patients who received standard physiotherapy plus manual lymph drainage; and a control group of 12 patients who received standard physiotherapy but no lymph drainage. The main outcome measure was the percentage reduction in excess limb volume, measured by the water displacement method at the second post-operative day (t1) and at the day of discharge (t2). RESULTS: Compared to the control group, a significant reduction in post-operative swelling was measured in the intervention group only (p = 0.011). CONCLUSIONS: Application of lymph drainage techniques after hindfoot operations, in combination with standard physiotherapy exercises, achieves greater limb volume reduction than exercise alone. The present study offers an insight into a treatment that may shorten rehabilitation and thereby control the cost of caring for post-operative treatment complicated by post-operative swelling.

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