The main objective of this study was to investigate the efficacy of complex decongestive therapy in patients with chronic venous insufficiency. Secondly, the suitability of manual lymphatic drainage, bandaging, and sequential pneumatic compression therapy – as key compression modalities of complex decongestive therapy – was examined.
Data sources
A search strategy was conducted in the Medline and Web of Knowledge electronic databases. The terms “chronic venous insufficiency”, “chronic venous disease”, “varicose veins”, “kinesio taping”, “pneumatic compression”, “multilayer bandage”, “manual lymphatic drainage”, and “complex decongestive therapy” were combined with of the Boolean Operators “OR” and “AND”.
Study selection
Ten articles exploring the efficacy of complex decongestive therapy in patients with chronic venous insufficiency were retrieved. The efficacy of the treatment and also the effectiveness of each of the maneuvers that make up the complex decongestive therapy studied separately as investigated.
Data extraction
Two researchers extracted the data from each study independently and cross-checked the results to eliminate any errors. The characteristics of each study were collected, including participants, demographic characteristics, intervention measures and performance, and study design.
Data synthesis
manual lymphatic drainage treatment decreased the venous reflux, edema, clinical severity, symptoms, and quality of life. Kinesio taping improved peripheral venous flow, ankle function, edema, pain, quality of life, venous symptoms, venous severity disease, and mental health. Sequential pneumatic compression increased venous blood flow and quality of life, while complex decongestive therapy reduced limb volume and pain intensity and improved activities of daily living.
Conclusions
The combined use of these techniques is proposed in the symptomatic treatment of VI, just as they are used in the treatment of lymphedema. However, further studies are needed to effectively assess CDT and define its treatment parameters.
MutlakOAslamMStandfieldNJ. Chronic venous insufficiency: a new concept to understand pathophysiology at the microvascular level - a pilot study. Perfusion2019; 34(1): 84–89.
SánchezFSLBECCSánchezcSD, et al.Determinantes de la gravedad en la insuficiencia venosa crónica. Estudio C-VIVES. Angiologia2013; 65(1): 1–9.
5.
VuylstekeMEColmanRThomisS, et al.An epidemiological survey of venous disease among general practitioner attendees in different geographical regions on the globe: the final results of the vein consult program: the final results of the vein consult program. Angiology2018; 69(9): 779–785.
6.
Cires-drouetRSFangyangLRosenbergerS, et al.High prevalence of chronic venous disease among health care workers in the United States. J Vasc Surg Venous Lymphat Disord2020; 8(2): 224–230.
7.
RabeEGoronFSalmatG. The prevalence, disease characteristics and treatment of chronic venous disease: an international web-based survey. J Comp Eff Res2020; 9(17): 1205–1218.
8.
GenselFAlhumamABruningG, et al.Population-based epidemiologic study in venous diseases in Germany – prevalence, comorbidity , and medical needs in a cohort of 19, 104 workers. Vasc Health Risk Manag2021; 17: 679–687.
9.
YounYJLeeJ. Chronic venous insufficiency and varicose veins of the lower extremities. Korean J Intern Med2019; 34(2): 269–283.
10.
DaviesAH. The seriousness of chronic venous disease: a review of real-world evidence. Adv Ther2019; 36(s1): 5–12.
11.
CrisóstomoRSDSCostaDSAMartinsCDLB, et al.Influence of manual lymphatic drainage on health-related quality of life and symptoms of chronic venous insufficiency: a randomized controlled trial. Arch Phys Med Rehabil2015; 96(2): 283–291.
12.
YamanyAHamdyB. Effect of sequential pneumatic compression therapy on venous blood velocity, refilling time, pain and quality of life in women with varicose veins: a randomized control studyrandomized control study. J Phys Ther Sci2016; 28(7): 1981–1987.
13.
NaciBOzyilmazSAygutalpN, et al.Effects of Kinesio Taping and compression stockings on pain, edema, functional capacity and quality of life in patients with chronic venous disease: a randomized controlled trial. Clin Rehabil2020; 34(6): 783–793.
14.
MutlakOSlamMADfieldNS. The influence of exercise on ulcer healing in patients with chronic venous insufficiency. Int Angiol2018; 37(2): 160–167.
15.
AraujoDNRibeiroCTDMacielACC, et al. Physical exercise for the treatment of non-ulcerated chronic venous insufficiency. Cochrane Database Syst Rev2016; 2016(12).
16.
ZasadzkaETrzmielTKleczewskaM, et al.Comparison of the effectiveness of complex decongestive therapy and compression bandaging as a method of treatment of lymphedema in the elderly. Clin Interv Aging2018; 13: 929–934.
17.
Executive Committee of the International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: 2020 consensus document of the international society of lymphology. Lymphology2020; 53: 3–19.
18.
PageMJMckenzieJEBossuytPM, et al.The PRISMA 2020 statement: the PRISMA 2020 statement: an updated guideline for reporting systematic reviews updated guideline for reporting systematic reviews. J Clin Epidemiol2021; 134:178–189.
19.
HigginsJPTThomasJChandlerJ, et al.Cochrane handbook for systematic reviews of interventions. Cochrane Handbook for Systematic Reviews of Interventions2019: 1–694.
20.
OlivoSAMacedoLGGadottiIC, et al.Scales to assess the quality of randomized controlled trials: a systematic review. Phys Ther2008; 88(2): 156–175.
21.
MolskiPOssowskiRHagnerW, et al.Patients with venous disease benefit from manual lymphatic drainage. Int Angiol2009; 28(2): 151–155.
22.
YamanyAHamdyB. Effect of sequential pneumatic compression therapy on venous blood velocity, refilling time, pain and quality of life in women with varicose veins: a randomized control study. J Phys Ther Sci2016; 28(7): 1981–1987.
23.
Aguilar-FerrándizMEMoreno-LorenzoCMatarán-PeñarrochaGA, et al.Effect of a mixed Kinesio taping-compression technique on quality of life and clinical and gait parameters in postmenopausal women with chronic venous insufficiency: double-blinded, randomized controlled trial. Arch Phys Med Rehabil2014; 95(7): 1229–1239.
24.
Aguilar-FerrándizMECastro-SánchezAMMatarán-PeñarrochaGA, et al.A randomized controlled trial of a mixed Kinesio taping-compression technique on venous symptoms, pain, peripheral venous flow, clinical severity and overall health status in postmenopausal women with chronic venous insufficiency. Clin Rehabil2014; 28(1): 69–81.
25.
MohamedWAIBadrNMFouadBE, et al.Efficacy of intermittent pneumatic compression on blood flow in patient with varicose veins. Arch Pharm Pract2020; 11(2): 149–153.
26.
TaradajJRosińczukJDymarekR, et al.Comparison of efficacy of the intermittent pneumatic compression with a high- and low-pressure application in reducing the lower limbs phlebolymphedema. Therapeut Clin Risk Manag2015; 11: 1545–1554.
27.
AlmeidaJIWakefieldTKabnickLS, et al.Use of the clinical, etiologic, anatomic, and pathophysiologic classification and venous clinical severity score to establish a treatment plan for chronic venous disorders. J Vasc Surg Venous Lymphat Disord2015; 3(4): 456–460.
28.
LurieFPassmanMMeisnerM, et al.The 2020 update of the CEAP classification system and reporting standards. J Vasc Surg Venous Lymphat Disord2020; 8(3): 342–352.
29.
MolskiPKruczyńskiJMolskiA, et al.Manual lymphatic drainage improves the quality of life in patients with chronic venous disease: a randomized controlled trial. Arch Med Sci2013; 9(3): 452–458.
30.
BakarYÖztürkACalisalMA, et al.Complete decongestive physiotherapy for older people with chronic venous insufficiency. Top Geriatr Rehabil2010; 26(2): 164–170.
31.
Coelho NetoFAraújoGRKesslerIM. Evaluation of quality of life and photoplethysmography in patients with chronic venous insufficiency treated with foam sclerotherapy. J Vasc Bras2015; 14(2): 145–152.
32.
HolmesCEBambaceNMLewisP, et al.Efficacy of a short course of complex lymphedema therapy or graduated compression stocking therapy in the treatment of post-thrombotic syndrome. Vasc Med2014; 19(1): 42–48.
33.
YesilHEyigörSCaramatİ, et al.Effects of complex decongestive therapy on quality of life, depression, neuropathic pain, and fatigue in women with breast cancer-related lymphedema. Turk J Phys Med Rehabil2017; 63(4): 329–334.
34.
BrandãoMLSoaresHPDSAndradeMDA, et al.Efficacy of complex decongestive therapy for lymphedema the lower limbs: a systematic review. J Vasc Bras2020; 19: 1–6.
35.
AbakayHDoğanHÇalişHT, et al.Is the effect of complex decongestive therapy the same for primary and secondary lower lymphedema?Lymphatic Res Biol2021; 19(2): 165–174.
36.
CorumMBasogluCKorkmazMD, et al.Effectiveness of combined complex decongestive therapy and resistance exercises in the treatment of lymphedema associated with breast cancer and the effect of pain on treatment response. Lymphatic Res Biol2021; 19(4): 383–390.
37.
de Moraes SilvaMANakanoLCUCisnerosLL, et al. Balneotherapy for chronic venous insufficiency. Cochrane Database Syst Rev2019; 2019(8).
38.
AurshinaAAscherEHingoraniA, et al.Clinical role of the “venous” ultrasound to identify lower extremity pathology. Ann Vasc Surg2017; 38: 274–278.
39.
QiaoTLiuCRanF. The impact of gastrocnemius muscle cell changes in chronic venous insufficiency. Eur J Vasc Endovasc Surg2005; 30(4): 430–436.
40.
Pajero OteroVGarcía DelgadoEMartín CortijoC, et al.Kinesio taping versus compression garments for treating breast cancer–related lymphedema: a randomized, cross-over, controlled trial. Clin Rehabil2019; 33(12): 1887–1897.
41.
TanICMausEARasmussenJC, et al.Assessment of lymphatic contractile function after manual lymphatic drainage using near-infrared fluorescence imaging. Arch Phys Med Rehabil2011; 92(5): 756–764.
42.
De GodoyJMPIozziAJAzevedoWF, et al.New method to assess manual lymph drainage using lymphoscintigraphy. Nucl Med Rev2012; 15(2): 140–142.
43.
dos Santos CrisóstomoRSCandeiasMSRibeiroAMM, et al.Manual lymphatic drainage in chronic venous disease: a duplex ultrasound study. Phlebology2014; 29(10): 667–676.
44.
ThompsonBGaitatzisKJanse de JongeX, et al.Manual lymphatic drainage treatment for lymphedema: a systematic review of the literature. J Cancer Surviv2021; 15(2): 244–258.
45.
Torres-LacombaMNavarro-BrazálezBPrieto-GómezV, et al.Effectiveness of four types of bandages and Kinesio-tape for treating breast-cancer-related lymphoedema: a randomized, single-blind, clinical trial. Clin Rehabil2020; 34(9): 1230–1241.
46.
SalhoferW. Etiology, nomenclature and pathophysiology of chronic venous insufficiency.pdf. Wien Med Wochenschr2016; 13: 264–269.
47.
SpiridonMCorduneanuD. Chronic venous insufficiency: a frequently underdiagnosed and undertreated pathology. Maedica2017; 12(1): 59–61.
