Vibrotherapy significantly improves the effectiveness of manual lymphatic drainage in women with lipoedema

The number of women suffering from lipoedema is constantly increasing. Conservative therapy involves manual lymphatic drainage (MLD), but this physiotherapeutic method does not always help, and its effectiveness depends on the severity and history of the disease. In view of the reports on the positive effect of vibrotherapy in reducing edema, scientists from RECON (Research and Consulting; Germany) decided to investigate the effect of MLD treatment combined with vibrotherapy on lipoedema and quality of life compared to the effects of MLD alone.

• After MLD treatment, there was only a slight reduction in lipoedema (changes ranged from 0.2 to 0.6 cm), while after combined treatment (MLD + vibration), lipoedema was significantly reduced (changes ranged from 0.6 to 2.6 cm).
• The magnitude of the change in thigh lipoedema due to vibration indicated a 99% advantage of the combination therapy compared to the MLD treatment alone.
• Patients receiving combination therapy reported a higher health-related quality of life score (23% improvement) than patients receiving MLD alone (8% improvement).

Prepared on the basis of:

Low-frequency vibrotherapy considerably improves the effectiveness of manual lymphatic drainage (MLD) in patients with lipedema: A two-armed, randomized, controlled pragmatic trial. Schneider R.  Physiother Theory Pract. 2020 Jan;36(1):63-70.

Study population

Thirty women with stage 2-3 lipoedema, referred for physiotherapy treatment, were studied.

Test procedure

Women were randomly assigned to the group subjected to 6 MLD treatments or combined therapy (6 MLD treatments + vibrotherapy during MLD). The volume of lipoedema in four locations of the lower (n = 29) or upper (n = 1) limbs as well as the quality of life were analyzed.

Use of vibration in the study

Patients undergoing vibration received the same MLD treatment as patients who did not receive vibration. This was done in such a way that during the MLD, patients were placed (whole body) on a table measuring 204 × 88 cm, which mechanically transmitted smooth, vertical vibrations generated by a motor mounted under the table, in accordance with the standardized Cellconnect Impuls software. The generated vibrations propagated as mild microflucations in the body fluids and cells, and thus could influence the functions and metabolism of cells. The program started with 15 Hz vibrations, and then, in every 3 min, the frequencies were increased until it reached 42 Hz.

Results

The size of the lipoedema

There were clear differences between the two treatments. After MLD treatment, there was only a slight reduction in the size of lipoedema, while after the combination therapy (MLD + vibration), there was a significant reduction in edema. Changes in the MLD group ranged from 0.2 to 0.6 cm, in the MLD + vibrations group – from 0.6 to 2.6 cm.

Analyzes of differential effects in the MLD + vibration group showed that in the case of a decrease in the forefoot circumference, the effect was d = 1.1 (95%CI: 0.5 <d <1.6), in the case of an ankle reduction d = 1.2 (95%CI: 0.6 <d <1.7), calf d = 1.7 (95%CI: 1.1 <d <2.3), and in the case of thighs there was the greatest decrease in circumference d = 2, 3 (95%CI: 1.6 <d <2.9). The magnitude of the latter effect indicated a 99% advantage of the combination treatment compared to MLD alone as 99% of the patients showed an improvement that was greater than the mean improvement in patients receiving MLD alone.

Quality of life

Consistent with the lipoedema reduction results, patients receiving combination therapy reported a higher quality of life at the end of treatment.

To assess the overall quality of life, 4 scales were combined separately, examining: physical fitness, negative mood level, ability to relax and positive mood level. There was a large vibration effect of d = 1.1 (95%CI: 0.5 <d <1.6), indicating that patients receiving combination therapy benefited more than patients receiving MLD alone. In the group of patients receiving only MLD, the quality of life improved by only about 8%, while the treatment with MLD + vibrations increased the quality of life by about 23%.

Comment

The obtained results prompted the authors of the presented scientific article to suggest that the combination of MLD with vibrotherapy radically increases the effectiveness of lipoedema treatment. The beneficial effects are deep, they are achieved quickly (compared to conventional therapies) and have a positive effect on health-related quality of life.

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