Recently, increased interest has focused on the phenomenon oflymphatic contractility. The thoracic duct and other lymph vessels appear to contract spontaneously to facilitate lymph flow with rate of contractions and their amplitude variable and dependent on different factors including fluid, concentration ofions or acidity, aging, drugs, or pathology. Not every lymph vessel remains contracting continuously with some seeming to completely stop their contractions due to various reasons. This may occur with no lymph flow within the vessel, or with very high flow, or it may be due to pathology or completely physiological conditions. Numerous studies have been conducted on this topic; however, their results may sometimes seem contradictory. In this review, upto-date publications have been collected and summarized to provide insights into the challenging topic ofspontaneous lymphatic contractility and factors affecting it. This area remains ofhigh research interest and newer techniques such as sonography may help to continue to shed light on the phenomenon of lymphatic contractility.
Recently, increased interest has focused on the phenomenon of lymphatic contractility. The thoracic duct and other lymph vessels appear to contract spontaneously to facilitate lymph flow with rate of contractions and their amplitude variable and dependent on different factors including fluid, concentration of ions or acidity, aging, drugs, or pathology. Not every lymph vessel remains contracting continuously with some seeming to completely stop their contractions due to various reasons. This may occur with no lymph flow within the vessel, or with very high flow, or it may be due to pathology or completely physiological conditions. Numerous studies have been conducted on this topic; however, their results may some-times seem contradictory. In this review, up-to-date publications have been collected and summarized to provide insights into the challenging topic of spontaneous lymphatic contractility and factors affecting it. This area remains of high research interest and newer techniques such as sonography may help to continue to shed light on the phenomenon of lymphatic contractility.
ICG lymphography is a lymphatic imaging tool that can inform lymphedema treatment, including self-management. Self-management requires patient engagement in a multimodal treatment program. However, lack of knowledge about lymphedema, challenges maintaining motivation, and lack of confidence in ability to perform self-management are barriers to engagement. This study aimed to determine if there was any change (immediate and/or delayed) to patient knowledge, motivation, confidence in lymphedema self-management, or lymphedema distress after undergoing ICG lymphography. A secondary aim was to observe health-related quality of life. A prospective observational repeated measures study followed 25 consecutive participants with limb lymphedema at three timepoints: pre; directly post; and, 12-months post ICG lymphography. A questionnaire exploring knowledge, motivation and confidence in self-management, along with lymphedema distress and a health-related quality of life tool were completed at each timepoint. Patients' knowledge about lymph-edema improved over all timepoints (p<0.001). Motivation for lymphedema self-management improvements trended toward significance directly post ICG lymphography (p=0.053), but was not maintained at 12-months. No other variables demonstrated significant change. Patients described the experience of undergoing ICG lymphography as positive and reported key learnings and changes to their self-management. ICG lymphography could be a useful tool to improve a person's knowledge of their lymphedema and may positively influence motivation to engage in self-management. Further exploration to sustaining motivation over time and potential im-pacts to lymphedema outcomes is necessary.
The primary study aim compared upper extremity (UE) functionality between breast cancer- related lymphedema (BCRL) patients and healthy controls. A secondary aim compared UE functionality based on lymphedema stage. The study included 50 women with unilateral BCRL and 50 healthy controls. UE functionality was assessed using the following measurement tools: the universal goniometer for range of motion (ROMs), digital inclinometer for proprioception, Semmes-Weinstein monofilament (SWM) test for light touch sensation, Upper Limb Functional Test (ULIFT) score for functionality and mobility, Disability of the Arm, Shoulder and Hand (DASH) for UE disability level, hand grip strength for peripheral muscle strength, and Upper Extremity Lymphedema Quality of Life questionnaire 27 (ULL-27) and Short Form 36-item Health Survey (SF-36) for quality of life (QoL). BCRL patients had reduced UE ROMs, UE functionality and mobility, hand grip strength, worse DASH score, impaired proprioception, light touch sensation and poorer quality of life compared to healthy controls (p<0.05). Significant between-group differences were detected in UE ROMs, ULIFT, DASH outcomes, proprioception, light touch sensation and physical and mental sub-scores of QoL assessments (p<0.05), while no significant differences were detected for hand grip strength, ULL-27 global score (p>0.05) according to lymphedema stage. Findings exhibited that patients with BCRL present with worse UE mobility, increased disability, loss of proprioception, impaired light touch sensation, and lower QoL compared to their healthy controls. UE functions and QoL may also vary between patients according to lymphedema severity.
