Avaliação da eficácia da drenagem linfática manual no tratamento da lipodistrofia ginoide
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Data
2013-08-28
Autores
Schonvvetter, Bianca [UNIFESP]
Orientadores
Bagatin, Edileia [UNIFESP]
Tipo
Dissertação de mestrado
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Fundamentos: A lipodistrofia ginoide, mais conhecida como celulite, refere-se à aparência ondulada e irregular da pele, afetando 80 a 90% das mulheres após a puberdade, preferencialmente nas coxas e regiões glúteas. A etiopatogenia é multifatorial e numerosos tratamentos têm sido sugeridos, com eficácia nem
sempre avaliada por métodos objetivos e quantitativos. Objetivos: verificar a eficácia e segurança da drenagem linfática manual na abordagem terapêutica da celulite. Material e Métodos: Estudo clínico aberto, prospectivo, de intervenção terapêutica, incluindo 20 mulheres com idades entre 20 e 40 anos. Realizadas14
sessões de drenagem linfática manual (técnicas de Vodder e Leduc), uma vez por semana, nos membros inferiores e regiões glúteas. Parâmetros de eficácia: opinião das pacientes e investigador, imagens fotográficas analisadas por observadores independentes, medidas antropométricas, bioimpedância elétrica, medida da elasticidade da pele, ultrassonografia de alta resolução e qualidade de vida. Resultados: 15 mulheres completaram o estudo. Houve melhora significativa na qualidade de vida (p=0,018). Nenhuma paciente relatou piora; 53% (8/15) relataram melhora e 47% (7/15) aspecto inalterado. Após o
tratamento, 33% (5/15) apresentaram melhora do grau de celulite e 64% (9/15) mantiveram o mesmo grau. Verificou-se redução significativa (p=0,023),
estimada em 0,3±0,8 cm, na circunferência do quadril, mas nas coxas não houve diferença significativa (p>0,05). Houve redução significativa da recuperação elástica da pele da região glútea, significando piora da elasticidade. As medidas
obtidas pela ultrassonografia não apresentaram diferenças significativas (p>0,05). Conclusão: A drenagem linfática manual mostrou-se segura mas
ineficaz quando aplicada isoladamente no tratamento da celulite, apesar da melhora significativa na qualidade de vida e redução da circunferência do quadril. Não foi possível estabelecer correlação entre as medidas
ultrassonográficas e os aspectos clínicos. Estudos randomizados, controlados ou comparativos sobre drenagem linfática manual isolada ou associada a outras modalidades terapêuticas são necessários.
Background: The gynoidlypodystrophy, known as cellulitis or cellulite, refers to ondulations or irregularities on skin surface of thighs and buttocks, affecting 80-90% of women after puberty. The etiopathogenesis is multifactorial and many treatments have been suggested with efficacy not evaluated by objective and quantitative methods. Objectives: to verify the efficacy and safety of manual lymphatic drainage for cellulite management. Material and Methods: open, prospective, therapeutic interventional clinical study, including 20 women, aged from 20 to 40. It was performed 14 sessions of manual lymphatic drainage (Vodder and Leduc technique), once a week, on limbs and buttocks. Efficacy parameters were: patients and investigator opinion, photography analyzed by independent observers, anthropometric measurements, electric bioimpedancy, skin elasticity measure, high resolution ultra-sound and quality of life. Results: 15 women completed the study. A significant improvement on quality of life was observed (p=0.018). None patient reported worsening; 53% (8/15) reported improvement and 47% (7/15) no alterations. After the treatment 33% (5/15) showed improvement in the cellulite degree and 64% (9/15) no difference. It was observed a significant reduction (p=0.023), estimated in 0.3±0.8 cm, in hip circumference, but no difference for thighs (p>0.05). A significant reduction elastic recuperation of skin on buttocks, which means skin elasticity worsening, was observed. All measures obtained by ultra-sound images showed no modifications (p>0.05). Conclusion: manual lymphatic drainage was safe but ineffective as unique approach for cellulite management, despite the quality of life improvement and hip circumference reduction. It was not possible to make any correlation between ultra-sound measures and clinical aspects. Further randomized, controlled or comparative studies about manual lymphatic drainage for cellulite control, as unique or combined therapeutic modality, are necessary.
Background: The gynoidlypodystrophy, known as cellulitis or cellulite, refers to ondulations or irregularities on skin surface of thighs and buttocks, affecting 80-90% of women after puberty. The etiopathogenesis is multifactorial and many treatments have been suggested with efficacy not evaluated by objective and quantitative methods. Objectives: to verify the efficacy and safety of manual lymphatic drainage for cellulite management. Material and Methods: open, prospective, therapeutic interventional clinical study, including 20 women, aged from 20 to 40. It was performed 14 sessions of manual lymphatic drainage (Vodder and Leduc technique), once a week, on limbs and buttocks. Efficacy parameters were: patients and investigator opinion, photography analyzed by independent observers, anthropometric measurements, electric bioimpedancy, skin elasticity measure, high resolution ultra-sound and quality of life. Results: 15 women completed the study. A significant improvement on quality of life was observed (p=0.018). None patient reported worsening; 53% (8/15) reported improvement and 47% (7/15) no alterations. After the treatment 33% (5/15) showed improvement in the cellulite degree and 64% (9/15) no difference. It was observed a significant reduction (p=0.023), estimated in 0.3±0.8 cm, in hip circumference, but no difference for thighs (p>0.05). A significant reduction elastic recuperation of skin on buttocks, which means skin elasticity worsening, was observed. All measures obtained by ultra-sound images showed no modifications (p>0.05). Conclusion: manual lymphatic drainage was safe but ineffective as unique approach for cellulite management, despite the quality of life improvement and hip circumference reduction. It was not possible to make any correlation between ultra-sound measures and clinical aspects. Further randomized, controlled or comparative studies about manual lymphatic drainage for cellulite control, as unique or combined therapeutic modality, are necessary.
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Citação
SCHONVVETTER, Bianca. Avaliação da eficácia da drenagem linfática manual no tratamento da lipodistrofia ginoide. São Paulo, 2013. 110 f. Dissertação (Mestrado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2013.