Stimulation of The Lymph Flow With Fascial Manipulation

Background: Lymphedema is chronical incurable disease of lymphatic system. In western countries it is mainly consequence of cancer treatment. Lymphedema is accompanied with repetitive inflammations and fibrotic changes of the affected tissue. They cause additional retention of the lymph. Complete decongestive therapy is used for conservative treatment of lymphedema in physiotherapy. Patients with lymphedema with changes in deep fascia were treated additionally with fascial. They showed additional reduction of lymphedema and prolonged effect of therapy. To our knowledge, no study has investigated impact of fascial manipulation on lymphedema. Hyaluronan has previously been suggested to act as a biomarker for lymphatic flow. Aim: The aim was to establish if fascial manipulation promotes lymph flow in healthy participants. Materials and methods: The study was conducted on 16 healthy participants (12 males, 4 females of mean age 25,5 years +/- SD 6,95, mean weight 74,93 +/- 15,98 kg). Blood samples were taken before and after fascial manipulation and were blood for plasma concentration of hyaluronic acid. Concentration of hyaluronic acid was assessed using highly sensitive immunofluorescence test. Results: Concentration of the blood plasma hyaluronan showed statistically significant decreases after fascial manipulation significant decrease after fascial manipulation from 17.85 ng/mL (11.17-22.85; min-max: 9.61-66.55 ng/mL) to 13.49 ng/mL (range: 8.07-19.95; min-max: 6.56-42.72 ng/mL) (p = 0.04). Our results suggest that fascial manipulation does not promote lymph flow in healthy subjects. The intervention did not have any undesired or unpredictable effects in healthy participants, future studies in lymphedema patients can be carried out using fascial manipulation.