The treatment of any disease should be grounded on basic principles including knowledge of the physiology, pathophysiology and therapeutic approaches that interfere in physiopathological mechanisms to reestablish the physiological balance. Cellulite is one of these diseases where the lack of a pathophysiological hypothesis hinders the identification of a therapy that can affect its pathophysiology in order to restore healthy cutaneous structures. Thus, the first question that should be asked when a treatment is proposed is whether the therapy is modifying the pathophysiology of the disease, so that the physiopathological condition can be reversed.
It was from this need that over the last 10 years Godoy & Godoy created a hypothesis for the pathophysiology of cellulite. They carried out clinical studies to confirm this hypothesis. This hypothesis is outlined in a book published in 1999 and was published in an American scientific journal in 2009. Further clinical studies have already been sent for publication in international journals and will soon be available to readers.
The hypothesis of the pathophysiology of cellulite was published in the journal: The Open Cardiovascular Surgery Journal (2009) and can be found on the site: www.drenagemlinfatica.com.br
Comments from the Mayo Clinic on the hypothesis of Godoy & Godoy can be accessed at:
Mechanical Lymphatic Therapy using the RAGodoy® device is the main form of intensive treatment of leg lymphedema. It is possible to reduce the volume of edema by 40-100% within one week of treatment using this approach, which drains both the deep and superficial lymphatic systems. Thus, this method is particularly useful to treat lymphedema after trauma and orthopedic surgeries. In fact, this technique is useful to treat all forms of lymphedema.
The goals of the RAGodoy® for the arms are the same as for the legs, to drain both the deep and superficial lymphatic systems. However, for the arms, the RAGodoy® device is more effective during the first hour of treatment after which it is recommended that the patient should have regular breaks or the Mechanical Lymphatic Therapy should be alternated with periods of Manual Lymphatic Therapy. Manual Lymphatic Therapy prioritizes the superficial lymphatic system and thus treatment of the limb is more complete. By associating Cervical Lymphatic Therapy (cervical stimulation), which, it is believed, stimulates contractions of lymphangions, completes the approach in terms of lymph drainage. Subfascial lymphatic collectors are important and they are stimulated using this technique.
The use of contention mechanisms is mandatory during treatment because lymphedema is chronic and there is no cure, but with the correct treatment, the size of the limb can be maintained normal or close to normal.
The evolution of the treatment of a disease occurs only when new forms of therapies are developed; this device constitutes a great advance. Several studies have demonstrated the effectiveness of this approach in reducing the volume of lymphedematous limbs.
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Lymph drainage, one of the main forms of lymphedema treatment, should be associated with contention mechanisms, and myolymphokinetic exercises and activities. The first manual lymph drainage technique was published by Emil and Astrid Vodder in 1936 in Paris. This technique was initially employed for aesthetical interventions but in the 1970s, it was included as a form of lymphedema treatment. The Földi couple improved lymphedema treatment by suggesting the association of lymph drainage with hygienic care, exercises and contention mechanisms. This association became known as complex physical therapy.
In the late 1990s, Godoy & Godoy, on trying to reproduce lymphedema treatment techniques scientifically, created new concepts and a new lymph drainage technique. This technique was developed following scientific principles where the entire intervention can be reproduced in the different phases of medical research (in vitro, in vivo and in the clinical practice). The technique has evolved over the years from draining the superficial lymphatic system of the extremities to draining the superficial and deep systems of the thorax and abdomen, to the concept of total lymph drainage involving the superficial and deep systems of the whole body. Cervical stimulation is a new development in lymph drainage. The hypothesis is that this new technique stimulates the contraction of lymphangions, sections of the lymphatics that act as miniature pumps. This stimulation is an important systemic lymph drainage process especially of the face. Cervical stimulation thus adds something extra to conventional lymph drainage.
One of the major contributions of cervical stimulation is its use in the treatment of congenital primary lymphedema. Primary congenital lymphedema, at around one in every 115,000 births, is rare but changes in the lymphatic system are marked and infants present with edema at birth or in their first two years of life. These children should receive treatment as early as possible because it prevents the progression to fibrosis making treatment is easier. Godoy & Godoy developed this specific approach to treatment and adapted it to the reality of the family and the child; it allows the control of the disease without major disruptions in the life of the child or expenditure on treatment.
Mechanical lymph drainage is the greatest revolution in treating lymphedema of both upper and lower limbs, because it saves time both for professionals and for patients. The RAGodoy® device is the main form of intensive treatment of lymphedema. It allows the patient to remain eight hours or more per day in treatment and with large reductions in the edema over a short time. It is possible to reduce the edema by 40-100% with one week of intensive treatment (40 hours) and in this way, patients can quickly return to their daily activities.
This device performs drainage of both the superficial and deep lymphatic systems in particular by activating the ‘lymph pump’ of the calf muscles. The main purpose of the venous system is to drain lymph in the superficial lymphatics to the deep lymphatic system. However, lymphatic collectors flow both to the deep system and to the superficial system. Thus, the use of this device makes drainage more complete.
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