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Journal of Phlebology and Lymphology

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Interference of gravitational pressure during active exercising of patients with lymphedema of the lower limbs

Author(s): José Maria Pereira de Godoy, Maria de Fátima Guerreiro Godoy, Flávia Mariana Valente

The adaptive mechanisms that prevent edema of the lower limbs when standing involve the action of muscles pumping fluids against the force of gravity. The objective of the current study was to evaluate the interference of gravitational pressure on active exercises of lower limbs with lymphedema. A total of 24 male and 5 female patients with a mean age of 34.6 and lymphedema of the lower limbs were evaluated. Volumetric evaluations were made before and after one hour performing three different activities utilizing the displacement of water technique similar to the method used by the ancient Greeks. Three different activities were utilized: 1) one hour laid down at rest with the affected limb on a sofa; 2) one hour with the limb supported on a sofa performing plantar bending and stretching exercises at about 20 to 30 movements per hour controlled by an observer and 3) one hour laid on a mattress performing plantar bending and stretching exercises at about 20 to 30 movements per hour also controlled by an observer. The student t‐test was employed for statistical analysis with an alpha error of 5% considered acceptable. The greatest volume losses were experienced by individuals exercising with the limbs supported on a sofa which when compared to the lowest reductions for exercises performed on a mattress gave a p‐value = 0.023. There was no significant difference between resting on the sofa and exercising on a mattress (p‐value = 0.59).