{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:53:30Z","timestamp":1791413610613,"version":"4.3.3"},"reference-count":36,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T00:00:00Z","timestamp":1708646400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cVilla Sana GmbH &amp; Co medizinische Produkte KG\u201d (Weiboldshausen, Germany)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Complex decongestive therapy (CDT) is the standard and basic therapy for lymphedema. The central component of CDT is manual lymphatic drainage (MLD). In addition to CDT, other measures such as intermittent pneumatic compression therapy (IPCT) (active compression machine therapy) are available. In this prospective research study, the objective and subjective effects of MLD and IPCT on lymphedema of the lower extremity were investigated and both therapies were directly compared. Furthermore, the patients\u2019 body mass index (BMI) and stage of lymphedema were tested for their effect on the respective therapy. Methods: Patients participating in the study received both therapies (MLD and IPCT) on the same lymphedema-affected limb at an interval of two days. The objective volumetric therapy effect was measured by the digital volume measurement of the affected limb. The subjective effects of the therapies were measured using two specially designed questionnaires. Results: A total of 40 patients were included in the study. There was no significant difference in the volume differences between the interventions, BMI categories, lymphedema, or treatment order regarding the immediate and two-day effect. Conclusions: No significant difference was found in the subjective or objective therapy efficacy of the two methods. Intermittent pneumatic compression therapy is considered a comparable therapeutic procedure when properly indicated.<\/jats:p>","DOI":"10.3390\/jcm13051277","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T10:47:30Z","timestamp":1708685250000},"page":"1277","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Therapist versus Machine\u2014Immediate Effects of Manual versus Mechanical Lymphatic Drainage in Patients with Secondary Lymphedema"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1096-9336","authenticated-orcid":false,"given":"Daniel","family":"Schiltz","sequence":"first","affiliation":[{"name":"Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"},{"name":"Department of Plastic and Aesthetic Surgery, Hand Surgery, Helios Hospital Emil von Behring, 14165 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Eibl","sequence":"additional","affiliation":[{"name":"Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5241-2945","authenticated-orcid":false,"given":"Karolina","family":"Mueller","sequence":"additional","affiliation":[{"name":"Center for Clinical Studies, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas","family":"Biermann","sequence":"additional","affiliation":[{"name":"Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2454-2499","authenticated-orcid":false,"given":"Lukas","family":"Prantl","sequence":"additional","affiliation":[{"name":"Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian Dirk","family":"Taeger","sequence":"additional","affiliation":[{"name":"Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Executive Committee of the International Society of Lymphology (2020). The diagnosis and treatment of peripheral lymphedema: 2020 Consensus Document of the International Society of Lymphology. Lymphology, 53, 3\u201319.","DOI":"10.2458\/lymph.4649"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1002\/pmic.200300573","article-title":"Proteomic analysis of lymph","volume":"4","author":"Leak","year":"2004","journal-title":"Proteomics"},{"key":"ref_3","first-page":"173","article-title":"Changes of tissue fluid hyaluronan (hyaluronic acid) in peripheral lymphedema","volume":"31","author":"Liu","year":"1998","journal-title":"Lymphology"},{"key":"ref_4","unstructured":"Koller, M.B.R., D\u00f6ller, W., F\u00f6ldi, E., Wilting, J., Ure, C., Brauer, W., F\u00f6ldi, M., and Albert, U. (2017). S2k Guideline \u2018Diagnostics and Therapy of Lymphoedema\u2019, AWMF. AWMF online."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1093\/qjmed\/hcg126","article-title":"Lymphoedema: An underestimated health problem","volume":"96","author":"Moffatt","year":"2003","journal-title":"QJM"},{"key":"ref_6","first-page":"193","article-title":"Quality-of-life and body image impairments in patients with lymphedema","volume":"39","author":"Roth","year":"2006","journal-title":"Lymphology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1002\/cncr.21195","article-title":"Psychologic and social sequelae of secondary lymphedema: A review","volume":"104","author":"McWayne","year":"2005","journal-title":"Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"279","DOI":"10.12968\/ijpn.2004.10.6.13270","article-title":"A phenomenological study of the lived experiences of people with lymphoedema","volume":"10","author":"Williams","year":"2004","journal-title":"Int. J. Palliat. Nurs."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1016\/j.jaad.2017.03.022","article-title":"Lymphedema: Pathophysiology and clinical manifestations","volume":"7","author":"Grada","year":"2017","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_10","first-page":"1","article-title":"Physiotherapeutic rehabilitation of lymphedema: State-of-the-art","volume":"51","author":"Tzani","year":"2018","journal-title":"Lymphology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e20200091","DOI":"10.1590\/1677-5449.200091","article-title":"Conservative treatment of lymphedema: The state of the art","volume":"20","author":"Bergmann","year":"2021","journal-title":"J. Vasc. Bras."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1016\/j.pmrj.2012.05.003","article-title":"A systematic review of the evidence for complete decongestive therapy in the treatment of lymphedema from 2004 to 2011","volume":"4","author":"Lasinski","year":"2012","journal-title":"PMR"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/1477-7819-11-15","article-title":"Effects of manual lymphatic drainage on breast cancer-related lymphedema: A systematic review and me-ta-analysis of randomized controlled trials","volume":"11","author":"Huang","year":"2013","journal-title":"World J. Surg. Oncol."},{"key":"ref_14","first-page":"87","article-title":"Localized tissue water changes accompanying one manual lymphatic drainage (MLD) therapy session assessed by changes in tissue dielectric constant inpatients with lower extremity lymphedema","volume":"41","author":"Mayrovitz","year":"2008","journal-title":"Lymphology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1684\/ejd.2022.4382","article-title":"Optimisation of intermittent pneumatic compression in patients with lymphoedema of the legs","volume":"32","author":"Konschake","year":"2022","journal-title":"Eur. J. Dermatol."},{"key":"ref_16","first-page":"e13625","article-title":"Intensive complex physical therapy combined with intermittent pneumatic compression versus Kinesio taping for treating breast cancer-related lymphedema of the upper limb: A randomised cross-over clinical trial","volume":"31","author":"Otero","year":"2022","journal-title":"Eur. J. Cancer Care"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1089\/lrb.2014.0010","article-title":"Intermittent Pneumatic Compression Enhances Formation of Edema Tissue Fluid Channels in Lymphedema of Lower Limbs","volume":"13","author":"Zaleska","year":"2015","journal-title":"Lymphat. Res. Biol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1089\/lrb.2018.0005","article-title":"The Effectiveness of Intermittent Pneumatic Compression in Therapy of Lymphedema of Lower Limbs: Methods of Evaluation and Results","volume":"17","author":"Zaleska","year":"2019","journal-title":"Lymphat. Res. Biol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1089\/lrb.2013.0033","article-title":"The effectiveness of intermittent pneumatic compression in long-term therapy of lymphedema of lower limbs","volume":"12","author":"Zaleska","year":"2014","journal-title":"Lymphat. Res. Biol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Kim, Y., Kim, S., Lim, J.Y., Hwang, C.M., Ko, M.-H., and Hwang, J.H. (2022). Home-Based Intermittent Pneumatic Compression Therapy: The Impact in Chronic Leg Lymphedema in Patients Treated for Gynecologic Cancer. Healthcare, 10.","DOI":"10.3390\/healthcare10040638"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1097\/PHM.0000000000000246","article-title":"Review of the evidence of lymphedema treatment effect","volume":"94","author":"Finnane","year":"2015","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"S18","DOI":"10.12968\/bjcn.2010.15.Sup3.47365","article-title":"Manual lymphatic drainage: Exploring the history and evidence base","volume":"15","author":"Williams","year":"2010","journal-title":"Br. J. Community Nurs."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1007\/s00105-018-4219-1","article-title":"S1 guideline on intermittent pneumatic compression (IPC)","volume":"69","author":"Breu","year":"2018","journal-title":"Hautarzt"},{"key":"ref_24","first-page":"393","article-title":"Quantitative volumetric analysis of the lower extremity: Validation against established tape measurement and water displacement","volume":"50","author":"Koban","year":"2018","journal-title":"Handchir. Mikrochir. Plast. Chir."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.zefq.2019.03.004","article-title":"Appropriateness of physiotherapy care in Germany: A scoping review","volume":"141\u2013142","author":"Peschke","year":"2019","journal-title":"Z. Evidenz Fortbild. Qual. Gesundheitswesen"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1055\/s-0037-1622142","article-title":"Beitrag zur Epidemiologie des Lymph\u00f6dems","volume":"35","year":"2006","journal-title":"Phlebologie"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2136","DOI":"10.1056\/NEJMc1201684","article-title":"Lower-extremity lymphedema and elevated body-mass index","volume":"366","author":"Greene","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_28","first-page":"56","article-title":"A randomized study comparing manual lymph drainage with sequential pneumatic compression for treatment of postoperative arm lymphedema","volume":"31","author":"Johansson","year":"1998","journal-title":"Lymphology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1089\/lrb.2009.0025","article-title":"Tissue fluid pressure and flow during pneumatic compression in lymphedema of lower limbs","volume":"9","author":"Olszewski","year":"2011","journal-title":"Lymphat. Res. Biol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1188\/08.ONF.671-680","article-title":"Home-based lymphedema treatment in patients with cancer-related lymphedema or noncancer-related lymphedema","volume":"35","author":"Ridner","year":"2008","journal-title":"Oncol. Nurs. Forum"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1007\/s12282-013-0481-3","article-title":"Efficacy of manual lymphatic drainage and intermittent pneumatic compression pump use in the treatment of lymphedema after mastectomy: A randomized controlled trial","volume":"22","author":"Uzkeser","year":"2013","journal-title":"Breast Cancer"},{"key":"ref_32","first-page":"188","article-title":"Intermittent pneumatic compression acts synergistically with manual lymphatic drainage in complex de-congestive physiotherapy for breast cancer treatment-related lymphedema","volume":"42","author":"Szolnoky","year":"2009","journal-title":"Lymphology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2260","DOI":"10.1002\/cncr.10976","article-title":"Decongestive lymphatic therapy for patients with breast carcinoma-associated lymphedema. A randomized, prospective study of a role for adjunctive intermittent pneumatic compression","volume":"95","author":"Szuba","year":"2002","journal-title":"Cancer"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1089\/lrb.2018.0034","article-title":"Intermittent Pneumatic Compression Dosage for Adults and Children with Lymphedema: A Systematic Review","volume":"17","author":"Phillips","year":"2019","journal-title":"Lymphat. Res. Biol."},{"key":"ref_35","first-page":"81","article-title":"Assessing Therapeutic Relationships in Physiotherapy: Literature Review","volume":"39","author":"Besley","year":"2011","journal-title":"N. Z. J. Physiother."},{"key":"ref_36","first-page":"423","article-title":"Effectiveness of manual lymphatic drainage and intermittent pneumatic compression in lymphedema maintenance therapy","volume":"52","author":"Mendoza","year":"2023","journal-title":"Vasa"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/5\/1277\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:03:58Z","timestamp":1760105038000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/5\/1277"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,23]]},"references-count":36,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["jcm13051277"],"URL":"https:\/\/doi.org\/10.3390\/jcm13051277","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,23]]}}}