Talk:Manual lymphatic drainage

I am not convinced

This Article presents nothing but hypotheses / suppositions-- and those are not adequately explored. I think Freud did a better job of obfuscating; he fooled a number of people for a number of years.

Science has a history of over-representation of results and folly; And *sciences* relating to human health are probably the worst offenders.

In contrast, the endeavor known as engineering can usually demonstrate its achievements. Mousetraps work; so do A-bombs. TheLordSayeth (talk) 14:04, 23 January 2012 (UTC)

Article needs sources, studies etc.

There are no sources to any sort of studies conducted about the effectiveness of lymphatic drainage massage.

Here's what a Google Scholar search turned up; https://scholar.google.fi/scholar?hl=en&q=lymphatic+drainage+massage&btnG=&as_sdt=1%2C5&as_sdtp=

Out of those, here's an example (study on MLD's effectiveness on treating lymphedema): http://www.tandfonline.com/doi/abs/10.1080/028418600750013186

Here's the abstract:

"A prospective randomized study was carried out to investigate whether the addition of manual lymphatic drainage (MLD) to the standard therapy could improve treatment outcome in women with lymphedema of the ipsilateral arm after breast cancer treatment. Forty-two patients were randomly assigned to receive standard therapy or standard therapy plus MLD 8 times in 2 weeks and training in self-massage. The standard therapy consisted of use of a compression garment, exercises and information about lymphedema and skin care. The efficacy of treatment was evaluated by reduction in lymphedema volume during treatment and by improvement in symptoms potentially related to lymphedema. The patients were followed-up for a total of 12 months. The study showed that both groups obtained a significant reduction in edema and that MLD did not contribute significantly to reduce edema volume." (Treatment of Breast-Cancer-related Lymphedema With or Without Manual Lymphatic Drainage: A Randomized Study, published in July 2009 by Lene Andersen, Inger Højris, Mogens Erlandsen & Jørn Andersen)

The researchers are Danish oncologists from the Aarhus University.

How many studies should be included? What kinds of studies? How long of a section should we dedicate to scientific studies of MLD? — Preceding unsigned comment added by 85.76.131.46 (talk) 09:25, 20 October 2016 (UTC)

Single studies are considered "primary" sources and are not eligible for inclusion in WP medical topics. A "metastudy" or "review" is needed. This means that the various primary sources, in this case individual studies, were reviewed, weighed, and put into context by a qualified author. Hope that helps clarify things. WP:MEDRS is the place to go for more info. --Karinpower (talk) 17:27, 20 October 2016 (UTC)

Reading sources and editing accordingly.

What the sources actually say.

There are three sources in this article that appear to brush close to the standards required by wp:medrs this is what they say

• [journal of manual and manipulative therapy]

   It concludes: Manual lymphatic drainage techniques remain a clinical art founded upon hypotheses, theory, and preliminary evidence. Researchers must strive to clarify the biophysical effects that underpin its various proposed therapeutic applications in the human organism. Randomized controlled trials and longitudinal prospective cohort studies are required to establish the efficacy of MLDTs in producing positive outcomes for patients rehabilitating from sports-related injuries.

• [SBU is an independent public authority]

   It concludes: Some  evidence  suggests  that  treatment  involving a  combination  of  compression  therapy  and  manual lymph  drainage  yields  reduced  edema  volume  compared to compression therapy alone if volume is measured  directly  after  the  conclusion  of  manual  lymph drainage  (Evidence  grade  3)*.  There  is  no  evidence to  show  that  this  effect  is  permanent.  Further  randomized controlled trials of sufficient size should be conducted – where treatment effects could be studied more closely in both the short and long term – before a  combination  of  compression  therapy  and  manual lymph drainage can be recommended.

• [World J Surg Oncol]

   It concludes: In conclusion, our meta-analysis indicated that the addition of MLD to compression and exercise therapy for the treatment of lymphedema after axillary lymph-node dissection for breast cancer is unlikely to produce a significant reduction in the volume of the affected arm. We found no significant difference in the incidence of lymphedema in patients treated with or without MLD. Overall, the methodological quality of the studies that we reviewed was poor. Based on the results of our meta-analysis, we cannot recommend the addition of MLD to compression therapy for patients with breast-cancer-related lymphedema.

The remaining sources are primary or promotional.

Based on this reading of the sources I will

• Place a critical summary of the efficiacy of the practice in the lede. Its current absence is an example of white washing by negating to mention important facts in the article's summary.
• Remove the sentence: MLD is now recognized as a primary tool in lymphedema management as based on the volume of criticism this seems unduely promotional.
• Rename the seciton "Recognition" to "Current practice" - Recognition seems to promote the idea that the section contains a list of "proof" as to the efficacy of the practice and is misleading as to what the section actually contains which is based on sources critical of the subject.
• Remove the word "gentle" from the description of the practice. This sounds like a marketing buzzword. The exact amount of pressure prescribed for this practice is listed in the lede already.

I will not edit the history section as it is OK to report what primary sources say about the subject in this section. I also won't edit the information on certification in the "Current practice" section as this is factual and accurate.

many thanks Edaham (talk) 03:06, 2 May 2017 (UTC)

Paragraph about the Godoy method removed

I saw a paragraph with oddly formatted sourcing plus an issue with the dating (the phrase "About 20 years later" needs to be a date). I started to fix that when I realized the sources were all from the same people, named Godoy, and was two self-published books plus one paper published on line that's been cited twice by others. There is little evidence their techniques or methods have been peer reviewed or widely used/studied/cited.

An article on the National Cancer Institute's web site on Lymphedema seems to be fairly comprehensive and has a section on Manual lymphedema therapy. They do not cite Godoy. I did a broader search using Google for site:cancer.gov "Godoy" which returns 10 hits but all of them were for other people named Godoy.

The paragraph I removed was:

About 20 years later, a new concept of manual lymphatic drainage, based on linear movements on the path of the lymphatic vessels towards the corresponding lymph nodes was developed by Godoy & Godoy. This technique was adapted later to the treatment of the secondary lymphedema where the main type of movement is the metorization of an intermittent compression therapy, specifically in lymphedema after treatment of breast cancer. [5-7]

The "[5-7]" sources had been appended to the bottom of the article as:

• 5-Godoy MFG, Godoy ACP, Godoy JMP. Manual Lymphatic Therapy: The Godoy & Godoy Concept. Kindle Edition (Amazon). São Jose do Rio Preto: THS, 2013. 167p.
• 6-De Godoy JMP, de Godoy ACP, Maria de FGG. Evolution of Godoy & Godoy manual lymph drainage. Technique with linear Movements. Clinics and Practice. 2017;7(4):1006. doi:10.4081/cp.2017.1006.
• 7-Maria de Fátima Guerreiro Godoy , Henrique José Pereira de Godoy, Jose Maria Pereira de Godoy. Transdisciplinary approach to rehabilitation of breast cancer-related lymphedema. United State: Amazon 2016. 220p.

Here are wikified sources in case someone finds WP:RS secondary, not primary sources for the Godoy's work:

• Godoy, Maria de Fatima Guerreiro; de Godoy, Ana Carolina Pereira; de Godoy, Jose Maria Pereira (December 16, 2014). Manual Lymphatic Therapy: The Godoy & Godoy Concept. CreateSpace Independent Publishing Platform. ISBN 1505585686. - This is for a later edition. The 2013 copy is out of print.
• de Godoy, José Maria Pereira; de Godoy, Ana Carolina Pereira; Godoy, Maria de Fatima Guerreiro (2017). "Evolution of Godoy & Godoy manual lymph drainage. Technique with linear Movements". Clinics and Practice. 7 (4): 1006. doi:10.4081/cp.2017.1006. PMID 29123640. - The cited journal published the third author name as "de Fatima Guerreiro Godoy Maria". This seems to be in error as she's credited as "Maria de Fátima Guerreiro Godoy" in both books. The second book has an Amazon Look Inside which confirms she should be credited as Maria de Fátima Guerreiro Godoy. I used the corrected name in the cite-journal.
• Godoy, Maria de Fátima Guerreiro; de Godoy, Henrique José Pereira; de Godoy, José Maria Pereira (July 20, 2016). Transdisciplinary approach to rehabilitation of breast cancer-related lymphedema. CreateSpace Independent Publishing Platform. ISBN 1535398884.

There is also a WP:COI issue in that the text about Godoy method was added by User:Maria de Fátima Guerreiro Godoy. --Marc Kupper|talk 05:48, 7 June 2018 (UTC)