02358nas a2200313   4500000000100000008004100001260001200042653001500054100001500069700001700084700001700101700001500118700001200133700001300145700001500158700001300173700001300186700001300199700001000212700001200222700001300234700001700247245019800264856004900462300000900511490000600520520150400526022001402030       2020                            d  bMDPI AG10aLymphedema1 aDouglass J1 aHailekiros F1 aMartindale S1 aMableson H1 aSeife F1 aBishaw T1 aNigussie M1 aMeribo K1 aTamiru M1 aAgidew G1 aKim S1 aBetts H1 aTaylor M1 aKelly-Hope L00aAddition of Lymphatic Stimulating Self-Care Practices Reduces Acute Attacks among People Affected by Moderate and Severe Lower-Limb Lymphedema in Ethiopia, a Cluster Randomized Controlled Trial  uhttps://www.mdpi.com/2077-0383/9/12/4077/pdf  a40770 v93 a<jats:p>Lymphedema causes disability and exacerbates poverty in many countries. The management of lymphatic filariasis (LF) and podoconiosis-related lymphedema involves daily hygiene to reduce secondary infections, but self-massage and deep-breathing, which have proven beneficial in cancer-related lymphedema, are not included. A cluster randomized trial in northern Ethiopia investigated the effects of lymphatic stimulation for people affected by moderate to severe lymphedema. Participants were allocated to either standard (control n = 59) or enhanced (intervention n = 67) self-care groups. Primary outcomes were lymphedema stage, mid-calf circumference, and tissue compressibility. Secondary outcomes were the frequency and duration of acute attacks. After 24 weeks, fewer patients were assessed as severe (control −37.8%, intervention −42.4%, p = 0.15) and there were clinically relevant changes in mid-calf tissue compressibility but not circumference. There was a significant between-group difference in patients who reported any acute attacks over the study period (control n = 22 (38%), intervention n = 7 (12%), p = 0.014). Daily lymphedema self-care resulted in meaningful benefits for all participants with a greater reduction in acute episodes among people performing lymphatic stimulation. Observations of a change in lymphedema status support earlier findings in Bangladesh and extend the demonstrated benefits of enhanced self-care to people affected by podoconiosis.</jats:p>  a2077-0383