PubMed · 13757433
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G KOEHLER. 1961-08-15. [Active exercise therapy in surgery].. https://pubmed.ncbi.nlm.nih.gov/13757433/
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Treatment of lymphedema utilizes complex physical (or decongestive) therapy (CDT), so-called. This covers a number of measures including compression, lymph drainage, skin care and individualized exercises. CDT is divided into two phases--an intensive phase during which daily treatment is applied over a period of two to four weeks, and a maintenance phase in which especially compression therapy is continued in order to secure the positive effects achieved during the first phase. Treatment should be initiated in an early stage of the condition, and the aim is to return the patient to the symptom-free latency stage. Neither isolated manual lymph drainage nor equipment-based decongestion is considered for the treatment of lymphedema. To date, the efficacy of various drugs, including selenium, has not been confirmed.
OBJECTIVE: To determine the effect of exercise training on survival in patients with heart failure due to left ventricular systolic dysfunction. DESIGN: Collaborative meta-analysis. Inclusion criteria Randomised parallel group controlled trials of exercise training for at least eight weeks with individual patient data on survival for at least three months. Studies reviewed Nine datasets, totalling 801 patients: 395 received exercise training and 406 were controls. MAIN OUTCOME MEASURE: Death from all causes. RESULTS: During a mean (SD) follow up of 705 (729) days there were 88 (22%) deaths in the exercise arm and 105 (26%) in the control arm. Exercise training significantly reduced mortality (hazard ratio 0.65, 95% confidence interval, 0.46 to 0.92; log rank chi(2) = 5.9; P = 0.015). The secondary end point of death or admission to hospital was also reduced (0.72, 0.56 to 0.93; log rank chi(2) = 6.4; P = 0.011). No statistically significant subgroup specific treatment effect was observed. CONCLUSION: Meta-analysis of randomised trials to date gives no evidence that properly supervised medical training programmes for patients with heart failure might be dangerous, and indeed there is clear evidence of an overall reduction in mortality. Further research should focus on optimising exercise programmes and identifying appropriate patient groups to target.