Jornal Vascular Brasileiro
https://app.periodikos.com.br/journal/jvb/article/doi/10.1590/1677-5449.006618
Jornal Vascular Brasileiro
Original Article

Funcionalidade e qualidade de vida em indivíduos com linfedema unilateral em membro inferior: um estudo transversal

Functionality and quality of life of patients with unilateral lymphedema of a lower limb: a cross-sectional study

Barbara Cristina de Sousa Pedrosa; Juliana Netto Maia; Ana Paula de Lima Ferreira; Maria das Graças Rodrigues de Araújo; Eduardo José Nepomuceno Montenegro; Fernando Leonel da Silva; Célia Maria Machado Barbosa de Castro; Maria do Amparo Andrade

Downloads: 3
Views: 1941

Resumo

Resumo: Contexto: O linfedema de membros inferiores é uma doença crônica decorrente de dano no sistema linfático que influencia a mobilidade, a funcionalidade e a qualidade de vida dos indivíduos. Questionários e o teste físico são métodos bastante práticos, de fácil aplicação e baixo custo, que fornecem dados importantes para a avaliação desses pacientes.

Objetivos: Avaliar a influência do linfedema unilateral de membro inferior na funcionalidade e na qualidade de vida, correlacionando três ferramentas de avaliação.

Métodos: Estudo descritivo com 25 indivíduos com linfedema unilateral em membro inferior, de ambos os sexos. Foi avaliada a perimetria e foram aplicados The Medical Outcome Study Short Form-36 Health Survey (SF-36) para avaliação da qualidade de vida, Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL) para estudo das habilidades físicas, mentais e sociais relacionadas ao linfedema e o Timed Up and Go (TUG) para avaliação da funcionalidade.

Resultados: Houve a presença de linfedema em todo o membro inferior dos participantes. Os domínios mais prejudicados pelo linfedema foram os aspectos físicos (25,0 ± 31,4) e emocionais (36,0 ± 42,9) no SF-36 e o domínio mobilidade (6,0 ± 2,6) no Lymph-ICF-LL. O TUG foi realizado em 9,88 ± 1,98 s. Houve correlação entre o TUG e os questionários e entre os dois questionários utilizados.

Conclusões: Indivíduos com linfedema unilateral em membro inferior apresentam um impacto negativo na qualidade de vida e na funcionalidade avaliadas através de questionários, que correlacionam entre si. Não foi encontrada alteração no TUG, mas houve correlação entre ele e os questionários utilizados.

Palavras-chave

linfedema, qualidade de vida, fisioterapia

Abstract

Abstract: Background: Lymphedema of the lower limbs is a chronic disease caused by damage to the lymphatic system that influences people’s mobility, functionality, and quality of life. Questionnaires and physical test are very practical, easy to apply, and low cost methods that provide important data for evaluation of these patients.

Objectives: To evaluate the influence of unilateral lower limb lymphedema on functionality and quality of life, correlating 3 assessment tools.

Methods: This was a descriptive study investigating 25 patients of both sexes with unilateral lymphedema in a lower limb. Limb volume was assessed using circumferential tape measurements, the Medical Outcomes Study Short Form-36 Health Survey (SF-36) was used to assess quality of life, the Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL) was used to assess physical, mental, and social skills related to lymphedema, and the Timed Up and Go (TUG) test was used for functional assessment.

Results: Lymphedema was present throughout the affected lower limb of participants. The domains most affected by lymphedema were physical aspects (25.0 ± 31.4) and emotional aspects (36.0 ± 42.9) from the SF-36 and the mobility domain (6.0 ± 2.6) from the Lymph -ICF-LL. Patients performed the TUG in 9.88 ± 1.98 seconds. The TUG was correlated with the questionnaires and the questionnaires were correlated with each other.

Conclusions: People with unilateral lower limb lymphedema exhibited negative impacts on quality of life and functionality, as evaluated by questionnaires, which were correlated with each other. TUG performance was within normal limits, but results correlated with the questionnaires used.
 

Keywords

lymphedema, quality of life, physical therapy

References

International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: consensus document of the International Society of Lymphology. Lymphology. 2013;46(1):1-11. PMid:23930436.

Tacani PM, Machado AFP, Tacani RE. Abordagem fisioterapêutica do linfedema bilateral de membros inferiores. Fisioter Mov. 2012;25(3):561-70. http://dx.doi.org/10.1590/S0103-51502012000300012.

Kafejian-Haddad AP, Garcia AP, Mitev AG, et al. Avaliação linfocintilográfica dos linfedemas dos membros inferiores: Correlação com achados clínicos em 34 pacientes. J Vasc Bras. 2005;4(3):283-9. http://dx.doi.org/10.1590/S1677-54492005000300011.

MacLean RT, Miedema B, Tatemichi SR. Breast cancer-related lymphedema: women’s experiences with an underestimated condition. Can Fam Physician. 2005;51:246-7. PMid:16926934.

Soares HPS, Rocha A, Aguiar-Santos AM, Silva BS, Melo CML, Andrade MA. Complex decongestant therapy with use of alternative material to reduce and control lymphedema in patients with endemic area of filariasis: a clinical trial. Fisioter Pesqui. 2016;23(3):268-77. http://dx.doi.org/10.1590/1809-2950/15476523032016.

Pereira CMA, Oliveira JC, Ciampone S, Marx A. Efeitos da linfoterapia em pacientes com linfedema de membros inferiores pós-infecção por erisipela. Rev Panam Flebol Linfol. 2009;12:728-36.

Cohen MD. Complete descongestive physical therapy in a patient with sencondary lymphedema due to orthopaedic trauma and surgery of the lower extremity. Phys Ther. 2011;91(11):1618-26. http://dx.doi.org/10.2522/ptj.20100101. PMid:21868611.

International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema. 2009 Concensus Document of the International Society of Lymphology. Lymphology. 2009;42(2):51-60. PMid:19725269.

Lawenda BD, Mondry TE, Johnstone PA. Lymphedema: a primer on the identification and management of a chronic condition in oncologic treatment. CA Cancer J Clin. 2009;59(1):8-24. http://dx.doi.org/10.3322/caac.20001. PMid:19147865.

Cemal Y, Jewell S, Albornoz CR, Pusic A, Mehrara BJ. Systematic review of quality of life and patient reported outcomes in patients with oncologic related lower extremity lymphedema. Lymphat Res Biol. 2013;11(1):14-9. http://dx.doi.org/10.1089/lrb.2012.0015. PMid:23531180.

Greene A, Meskell P. The impact of lower limb chronic oedema on patients’ quality of life. Int Wound J. 2017;14(3):561-8. http://dx.doi.org/10.1111/iwj.12648. PMid:27489034.

Franks PJ, Moffatt CJ, Doherty DC, Williams AF, Jeffs E, Mortimer PS. Assessment of health-related quality of life in patients with lymphedema of the lower limb. Wound Repair Regen. 2006;14(2):110-8. http://dx.doi.org/10.1111/j.1743-6109.2006.00099.x. PMid:16630098.

Finnane A, Hayes SC, Obermair A, Janda M. Quality of life of women with lower-limb lymphedema following gynecological cancer. Expert Rev Pharmacoecon Outcomes Res. 2011;11(3):287-97. http://dx.doi.org/10.1586/erp.11.30. PMid:21671698.

Lee TS, Morris CM, Czerniec SA, Mangion AJ. Does lymphedema severity affect quality of life? Simple question. challenging answers. Lymphat Res Biol. 2018;16(1):85-91. http://dx.doi.org/10.1089/lrb.2016.0049. PMid:28453410.

Thomas C, Narahari SR, Bose KS, et al. Comparison of three quality of life instruments in lymphatic filariasis: DLQI, WHODAS 2.0, and LFSQQ. PLoS Negl Trop Dis. 2014;8(2):e2716. http://dx.doi.org/10.1371/journal.pntd.0002716. PMid:24587467.

Ferreira KR, Carvalho RB, Andrade MF, Thuler LC, Bergmann A. Translation and cross-cultural adaptation of the lymphoedema functioning, disability and health questionnaire for lower limb lymphoedema into portuguese language. Rev Bras Ginecol Obstet. 2016;38(2):88-96. http://dx.doi.org/10.1055/s-0036-1571471. PMid:26909773.

Stolldorf DP, Dietrich MS, Ridner SHA. Comparison of the quality of life in patients with primary and secondary lower limb lymphedema: a mixed-methods study. West J Nurs Res. 2016;38(10):1313-34. http://dx.doi.org/10.1177/0193945916647961. PMid:27151079.

Viehoff PB, Hidding JT, Heerkens YF, van Ravensberg CD, Neumann HA. Coding of meaningful concepts in lymphedema-specific questionnaires with the ICF. Disabil Rehabil. 2013;35(25):2105-12. http://dx.doi.org/10.3109/09638288.2013.771710. PMid:23480645.

Devoogdt N, De Groef A, Hendrickx A, et al. Lymphoedema Functioning, Disability and Health Questionnaire (Lymph-ICF): reliability and validity. Phys Ther. 2014;94(5):705-21. http://dx.doi.org/10.2522/ptj.20130285. PMid:24415775.

Miller AJ, Bruna J, Beninson J, Miller AJ. A universally applicable classification of lymphedema. Angiology. 1999;50(3):189-92. http://dx.doi.org/10.1177/000331979905000302. PMid:10088797.

Ciconelli RM, Ferraz MB, Santos W, Meinão I, Quaresma MR. Tradução para a língua portugues e validação do questionário genérico de avaliação de qualidade de Vida SF-36 (Brasil SF-36). Rev Bras Reumatol. 1999;39:143-50.

Ferreira APM, Figueiredo EM, Lima RA, et al. Quality of life in women with vulvar cancer submitted to surgical treatment: a comparative study. Eur J Obstet Gynecol Reprod Biol. 2012;165(1):91-5. http://dx.doi.org/10.1016/j.ejogrb.2012.06.027. PMid:22795579.

Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-8. http://dx.doi.org/10.1111/j.1532-5415.1991.tb01616.x. PMid:1991946.

Figueiredo KMOB, Lima KC, Guerra RO. Instrumentos de avaliação do equilíbrio corporal em idosos. Rev Bras Cineantropom Desempenho Hum. 2007;9:408-13.

Oremus M, Dayes I, Walker K, Raina P. Systematic review: conservative treatments for secondary lymphedema. BMC Cancer. 2012;12(1):1471-2407. http://dx.doi.org/10.1186/1471-2407-12-6. PMid:22216837.

Santana JR, Souza MML, Brandão E, et al. Perfil de pacientes com linfedema atendidos no Serviço de Referência Nacional em Filarioses da Fundação Oswaldo Cruz, Pernambuco, Brasil. Rev Patol Trop. 2016;45(4):387-97. http://dx.doi.org/10.5216/rpt.v45i4.44607.

Carvalho ATY, Pereira MCSB, Santos AJ, et al. Impacto dos marcadores socioeconômicos na gravidade do linfedema das extremidades inferiores. J Vasc Bras. 2011;10(4):298-301. http://dx.doi.org/10.1590/S1677-54492011000400007.

Dreyer G, Mattos D, Figueredo-Silva J, Norões J. Mudanças de paradigmas na filariose bancroftiana. Rev Assoc Med Bras. 2009;3(55):355-62. http://dx.doi.org/10.1590/S0104-42302009000300032. PMid:19629359.

Flor LS, Campos MR. The prevalence of diabetes mellitus and its associated factors in the Brazilian adult population: evidence from a population-based survey. Rev Bras Epidemiol. 2017;20(1):16-29. http://dx.doi.org/10.1590/1980-5497201700010002. PMid:28513791.

American Physical Therapy Association. Guide to physical therapist practice 2nd ed. Alexandria: APTA; 2001.

Laguardia J, Campos MR, Travassos C, Najar AL, Anjos LA, Vasconcellos MM. Brazilian normative data for The Short Form 36 questionnaire, version 2. Rev Bras Epidemiol. 2013;16(4):889-97. http://dx.doi.org/10.1590/S1415-790X2013000400009. PMid:24896594.

Gethin G, Byrne D, Tierney S, Strapp H, Cowman S. Prevalence of lymphoedema and quality of life among patients attending a hospital-based wound management and vascular clinic. Int Wound J. 2012;9(2):120-5. http://dx.doi.org/10.1111/j.1742-481X.2011.00851.x. PMid:21910829.

Farrelly I. The importance and function of footwear in managing lymphoedema. Br J Community Nurs. 2008;13(10):10-4. http://dx.doi.org/10.12968/bjcn.2008.13.Sup5.31190. PMid:19057476.
 

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5cd986360e88254e6c86c886 jvb Articles

J Vasc Bras

Share this page
Page Sections