Manual Edema Mobilization

Artzberger, Sandra M.; Priganc, Victoria

doi:10.1016/b978-0-323-05602-1.00065-9

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…Recent evidence suggests that massage needs to be much lighter with only minimal pressure to traction the skin. 7 It should start and end proximally to clear lymph channels proximally and make way for fluid distributed distally. This technique referred to as manual edema mobilization (MEM) 7 is complimented with other methods aimed to assist with the facilitated direction of lymphatic flow which include low-stretch bandaging and a home exercise program.…”

Section: Introductionmentioning

confidence: 99%

“… 7 It should start and end proximally to clear lymph channels proximally and make way for fluid distributed distally. This technique referred to as manual edema mobilization (MEM) 7 is complimented with other methods aimed to assist with the facilitated direction of lymphatic flow which include low-stretch bandaging and a home exercise program. MEM massage does not involve pressure and in effect is more of a stroking action where the hand is brushed across the skin with only enough force to gently drag on the skin to the point at which it creases.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of edema management techniques for subacute hand edema: A systematic review

Miller

Shepstone

2017

Journal of Hand Therapy

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Study DesignSystematic review.IntroductionProlonged hand edema can have detrimental effects on range of motion and function. There is no consensus on how best to manage traumatic subacute edema. This is the first systematic review which examines the clinical effectiveness of edema treatments on hand volume.Purpose of the StudyThe purpose of this systematic review was to examine the evidence of effectiveness of treatments for sub-acute hand edema.MethodsA literature search of AMED, CINAHL, Embase, and OVID MEDLINE (from inception to August 2015) was undertaken. Studies were selected if they met the following inclusion criteria: randomized controlled or controlled trials in adults who have subacute swelling after a recent upper limb musculoskeletal trauma or cerebral vascular attack or after surgery. Two independent assessors rated study quality and risk of bias using the 24-point MacDermid Structured Effectiveness Quality Evaluation Scale (SEQES).ResultsTen studies met the inclusion criteria. Study quality ranged from 23 to 41 out of 48 points on the SEQES. A total of 16 edema interventions were evaluated across the studies. Due to heterogeneity of the patient characteristics, interventions, and outcomes assessed, it was not possible to pool the results from all studies. Therefore, a narrative best evidence synthesis was undertaken. There is low to moderate quality evidence with limited confidence in the effect estimate to support the use of manual edema mobilization methods in conjunction with standard therapy to reduce problematic hand edema.ConclusionManual edema mobilization techniques should be considered in conjunction with conventional therapies, in cases of excessive edema or when the edema has not responded to conventional treatment alone; however, manual edema mobilization is not advocated as a routine intervention.Level of Evidence2b.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effectiveness of edema management techniques for subacute hand edema: A systematic review

Miller

Shepstone

2017

Journal of Hand Therapy

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Post-Traumatic Contracture

Mee

Trail

2014

Disorders of the Hand

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Immediate mobilization of distal radius fractures stabilized by volar locking plate results in a better short-term outcome than a five week immobilization: A prospective randomized trial

et al. 2021

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Objective: To evaluate the impact of immediate (first day after surgery) mobilization compared to standard five weeks cast immobilization on the functional outcome after volar locking plate fixation of distal radius fractures. Design: Prospective randomized parallel group comparative trial. Setting: Trauma Hospital, Austria. Participants: Patients with isolated unstable distal radius fractures, stabilized with volar angular stable locking plate. Interventions: The immediate mobilization group received a removable forearm splint for one week and active supervised group physiotherapy and home exercises for the shoulder, elbow, wrist, and fingers from the first postoperative day. The cast immobilization group received a non-removable cast for five weeks. In the first five weeks supervised group physiotherapy and home exercises were performed for shoulder, elbow, and fingers. Thereafter additional supervised and home exercises for the wrist were started. Main measures: At regular intervals of six and nine weeks, three and six months, and one year post surgery range of motion, grip strength, and x-rays were evaluated. Additionally, the shortened disabilities of the arm, shoulder and hand ( QuickDASH) score, Patient-rated Wrist Evaluation, Mayo Wrist score, and pain according to the Visual Analog Scale score were analyzed. Results: One hundred and sixteen patients were prospectively randomized into two study groups. At the one-year follow-up, patients in the immediate mobilization group showed a significantly higher range of motion in extension/flexion (mean difference 10.2°, 99% confidence interval 0.6–19.8), grip strength (mean difference 5.1 kg, 99% confidence interval −0.5 to 10.7), and Mayo Wrist score (mean difference 7.9 points, 99% confidence interval 2.3–13.5) than the cast immobilization group. Range of motion in supination/pronation (mean difference 13.4°, 99% confidence interval 1.5–25.3) and in radial/ulnar deviation (mean difference 6.3°, 99% confidence interval 0.9–11.7) differed significantly up to nine weeks favoring the immediate mobilization group. The Patient-rated Wrist Evaluation revealed significantly better scores after three months (mean difference 9.3 points, 99% confidence interval 0.5–18.1) and QuickDASH after six months (mean difference 7.3 points, 99% confidence interval 0.3–14.3) in the immediate mobilization group. All other subsequent follow-up examinations indicated no significant differences in respect of pain, range of motion, and patient-reported outcome measurements between the study groups. There were no significant differences in respect of radiological loss of reduction and complications between the groups. Conclusions: Immediate mobilization in combination with supervised physiotherapy of the wrist after volar locking plate fixation of unstable distal radius fractures results in a significantly improved range of motion and grip strength after one year compared to cast immobilization. No increased risk for loss of reduction and other complications was observed.

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Manual Edema Mobilization

Cited by 3 publications

References 15 publications

Effectiveness of edema management techniques for subacute hand edema: A systematic review

Effectiveness of edema management techniques for subacute hand edema: A systematic review

Post-Traumatic Contracture

Immediate mobilization of distal radius fractures stabilized by volar locking plate results in a better short-term outcome than a five week immobilization: A prospective randomized trial

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