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Background Peripheral nerve damage can have debilitating consequences. Rabbit sciatic nerve transection models allow the effective evaluation of surgical repair strategies for large nerve gaps. Despite advantages in size, ease of handling, and functional utility, rabbits can suffer from a number of side effects that affect animal welfare and the quality of scientific inquiry. Such side-effects, which include pressure ulcers and traumatic damage to the foot, are primarily a consequence of insensitivity of the distal hindlimb following sciatic nerve injury. In this study, we present a number of methodologies for identifying, treating, and preventing unintended adverse effects in rabbit sciatic nerve injury models. Results First, we categorize pressure ulcers according to their severity and describe the deployment of a padded bandaging technique to enable ulcer healing. We also introduce a proactive bandaging approach to reduce the likelihood of pressure ulcer formation. Second, we define phenotypes that distinguish between foot injuries resulting from self-mutilation (autotomy) from those caused by incidental traumatic injury secondary to sensori-motor damage. Finally, we detail an effective strategy to reduce the usage of Elizabethan collars; through a gradual weaning protocol, their usefulness in preventing autotomy is retained, while their propensity to impede rabbit grooming and cause abrasion-injury to the neck region is minimized. Conclusions We suggest that application of these methods offer a practical and systematic approach to avoid adverse side effects associated with rabbit sciatic nerve damage, enabling improved animal welfare and scientific outcomes in a powerful nerve injury model.

Background and Objective: Hypotension is a common complication of cesarean section with spinal anesthesia, which can be dangerous for both mother and neonatal. The aim of this clinical trial study was to investigate the effect of using bandaging on the lower limbs in preventing of post spinal hypotension in cesarean section. Materials and Methods: This prospective clinical trial study was performed in 2019-2020 at Fatemieh Hospital in Hamadan. A total of 64 patients undergoing cesarean section with spinal anesthesia were randomly divided into two groups of with bandaging at the time of surgery and without bandaging. Demographic information, hemodynamic status in the first hour after spinal anesthesia, hypotension, nausea and vomiting, bradycardia, tachycardia, atropine levels, ephedrine consumed, was compared in both groups. The data were statistically analyzed by SPSS version 16 software and analyzed. Results: The mean age of both groups of patients was approximately 30 years (P = 0.958). Hypotension (25 vs. 78.1%), bradycardia (9.3 vs. 15.6%) and intraoperative nausea and vomiting (12.5 vs. 59.4%) in the intervention group with significantly less than the control group. The amount of ephedrine (4.1 3 3.1 vs. 20.6 13 13.2 mg) was lower in the intervention group than in the control group (P = 0.01). In the study of hemodynamic status of systolic and diastolic pressure from 2 to 6 minutes and mean arterial pressure from 2 to 10 minutes after spinal with a significant difference in the intervention group was more than the control group (P

The purpose of this systematic review was to produce a best evidence synthesis of the effects of Kinesiology Tape (KT) in the treatment of tendinopathies. An electronic search on five databases (PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, SportDiscus, and Physiotherapy Evidence Database (PEDro)) was conducted. Studies were included if (1) patients suffered from tendinopathy; (2) isolated KT was applied in at least one group; (3) comparisons between other techniques were developed; (4) outcomes based on pain, function, disability, or quality of life were analysed. Two reviewers independently extracted data and assessed methodological quality using the Physiotherapy Evidence Database (PEDro) scale. A total of 13 articles met the eligibility criteria, involving 454 participants. Nine of these studies presented upper extremity tendinopathies, and four explored lower extremity tendinopathies. Selected papers ranged from low to high quality, with an average score of 5 on the PEDro scale. According to our findings, there is limited evidence to support KT alone for the treatment of tendinopathies beyond the short-term. Due to the mixed methodological quality and the insufficient number of clinical trials, larger, long-term, high-quality studies are needed to support the theory that tendinopathies can benefit from KT applications.

Background: Compression is a cornerstone modality in edema treatment. Different types of bandages are available in clinical practice. Short-stretch bandages are commonly used; however, newer technologies such as the two-component compression system are available as well. This study assesses the pressure curves and static and dynamic stiffness (Static Stiffness Index [SSI] and Dynamic Stiffness Index [DSI]) of two different two-component compression systems, Coban and CoFlex, for edema treatment. Methods and Results: For this prospective cohort study, 12 healthy volunteers were recruited. The healthy volunteers wore both two-component compression systems for 48 hours. Pressure sensors (PicoPress®; Microlab, Italy) were placed at 10 and 25 cm above the internal malleolus and 10 pressure readings were used to obtain pressure curves. The SSI and DSI were assessed. Additionally, comfort (ICC compression questionnaire) and adverse events were assessed as well. Both two-component compression systems exert a sufficient amount of sub-bandage pressure, although CoFlex exerts systematically significantly lower pressure in comparison with Coban. This difference in sub-bandage pressure remains constant over 48 hours. Both two-component compression systems are sufficiently stiff (stiffness >15 mmHg) and remain stiff over time. Conclusions: Both two-component compression systems have pressure curves that are high enough to motivate their use in the treatment of chronic edema. Additionally, both systems were found to be comfortable and have clinically effective SSI and DSI values. ispartof: LYMPHATIC RESEARCH AND BIOLOGY vol:20 issue:3 pages:335-341 ispartof: location:United States status: published

Objectives: The aim of this study was to evaluate the comparative efficacy of 3MTM CobanTM 2 layer system and conventional multi-layer short-stretch bandaging in terms of volume reduction, ultrasonographic measurements, functional status, and quality of life (QoL) in the treatment of patients with breast cancer-related lymphedema (BCRL). Patients and methods: This prospective, single-blind, randomized study included a total of 60 BCRL patients (60 females; mean age 54.9±9.6 years; range, 30 to 73 years). The patients were randomly allocated to Group 1 (n=30) and Group 2 (n=30). Both groups received complex decongestive therapy (CDT) including skin care, lymphedema exercises, and manual lymphatic drainage (MLD) combined with traditional multi-layer short-stretch bandaging five times per week for three weeks in Group 1 and with 3MTM CobanTM 2 layer system bandaging two times per week for three weeks in Group 2. Differences in volumes, excess volumes, ultrasonographic measurements, QoL, and functional assessment scores were evaluated at baseline, after three weeks of intensive treatment period, and at two months of follow-up. Functional status was evaluated by the Quick Disability of Arm Shoulder and Hand Questionnaire (Q-DASH), while the QoL was assessed using the Turkish version of Lymphedema Quality of Life Questionnaire-Arm (LYMQOL-Arm). The duration and easiness of applying bandages by physiotherapists and comfortableness of bandages according to patients and physiotherapists were also evaluated using a questionnaire. Results: The demographic and clinical properties were similar between the groups. There were significant improvements in the volumes, excess volumes, ultrasonographic measures, functional scores, and QoL scores in both groups at the end of treatment. The improvements were sustained at two months of follow-up. Conclusion: The 3MTM CobanTM 2 layer bandaging as a part of CDT twice a week for a period of three weeks can significantly reduce the volume and improve the disability and impaired QoL, similar to conventional short-stretch multi-layer bandages. In addition, treatment with this layer system enables a time-efficient, easy, and comfortable application of bandaging with increased mobility of the upper extremity.

Background: Despite of all the problems caused by lymphedema, this disease continues to affect millions of people worldwide. Thus, the identification of the most efficacious forms of treatment is necessary. Aim: The aim of this study was to evaluate a novel intensive outpatient treatment for leg lymphedema. Methods: Twenty-three legs of 19 patients were evaluated in a prospective randomized study. The inclusion criteria were patients with Grade II and III lymphedema, where the difference, measured by volumetry, between the affected limb below the knee and the healthy limb was greater than 1.5 kg. Intensive treatment was carried out for 6- to 8-h sessions in the outpatient clinic. Analysis of variance was utilized for statistical analysis with an alpha error of 5% (P-value

ObjectiveTo define the pressures and gradients achieved by different bandages when applied by alternative bandaging techniques.MethodsAn experienced bandager applied six bandages to the same leg of a volunteer using three application techniques. Pressure measurements were taken at the ankle, gaiter, calf and upper calf in three postures.ResultsAll bandages gave consistent pressures with all standard deviations falling below 7mmHg. The percentage increase in pressure from resting leg to standing was inversely related to bandage elasticity. Pressures were similar at the upper calf among the bandages for each application technique in each posture (differences

International audience; OBJECTIVE:Lymphedema treatment is based on Decongestive Lymphedema Therapy (DLT) with an intensive phase followed by a long-term maintenance phase. This study aimed to observe volume variation over the intensive phase and 6 months later.METHODS:Prospective multicentre observational study of patients with unilateral lymphedema. The primary objective was to assess lymphedema volume variation between baseline, the end of intensive phase and 6 months later. Secondary objectives were to assess the frequency of heaviness limiting limb function and treatments safety predictors for volume reduction.RESULTS:Three hundred and six patients (89.9% women; 59.9±14.3 years old) with upper/lower (n=184/122) limb lymphedema were included. At the end of the intensive phase, median excess lymphedema volume reduction was 31.0% (41.7-19.9) followed by a 16.5% (5.9-42.3) median increase over the 6-month maintenance period phase. Previous intensive treatment was the only significant predictor of this response. As compared to baseline, heaviness limiting limb use was much less frequently reported at the end of the reductive phase (75.5% versus 42.3% respectively), and was more frequent at the end of the maintenance phase (62.6%). The most frequent adverse events reported were skin redness and compression marks (18.4 and 15.7% of patients, respectively). Blisters requiring treatment stoppage were rare (1.4%).CONCLUSIONS:Intensive phase decreases lymphedema volume and heaviness limiting limb function. The benefit is partially abolished after the first 6 months of maintenance. There is a need to consider how to provide optimal patient care for the long-term control of lymphedema.