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Am J Phys Med Rehabil. 2013 Aug;92(8):697-703. doi: 10.1097/PHM.0b013e318282c721.

Postural drainage and manual lymphatic drainage for lower limb edema in women with morbid obesity after bariatric surgery: a randomized controlled trial.

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College of Health Science, Methodist University of Piracicaba, São Paulo, Brazil.



The aim of this study was to evaluate the effects of postural drainage (PD) and manual lymphatic drainage (MLD) techniques on edema in the lower limbs of women with morbid obesity submitted to bariatric surgery.


A total of 47 women between 20 and 40 yrs old with a body mass index of 40 kg/m or higher were randomly placed in three groups: control group (n = 15), PD group (PDG, n = 16), and MLD group (n = 16). Lower limb perimetry was carried out in the first and third days of the postoperative period. All patients underwent six sessions of conventional physical therapy, plus additional six sessions of PD for the PDG or six sessions of MLD for the MLD group.


Intragroup analysis showed volume reductions in the PDG and the MLD group after the treatment protocol. Comparison of the pretreatment and posttreatment deltas among the groups showed a larger change in volume for the PDG compared with the control group and a larger change in volume for the MLD group compared with the control group or the PDG.


The treatment protocols promoted reductions in volume values, suggesting that both techniques could be used to help reduce lower limb edema among this population. Nevertheless, the best results were obtained with MLD.

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