Physiotherapy and rehabilitation applications in lipedema management: A literature review.

Lipedema is a chronic and progressive disease of adipose tissue caused by abnormal fat accumulation in subcutaneous tissue. Although there is no known cure for lipedema, possible complications can be prevented with conservative and surgical treatments. One of the conservative treatment options is physiotherapy and rehabilitation (PR). When the literature is examined, few studies focusing on the efficacy of PR were found for this patient group. The purpose of this review is to provide a better understanding of the effectiveness of PR applications by compiling existing studies. A bibliographic PubMed search was performed for published studies regarding PR in lipedema management in June 2019 including the last 58 years (1951-2019). Articles were chosen by reading the abstracts and subsequently data were analyzed by reading the entire text through full-text resources. A total of 15 studies met inclusion criteria. Results document how lipedema patients are benefited by PR and the effectiveness of different types of PR programs. The current review also showed that complex decongestive physiotherapy, gait training, hydrotherapy, aerobic exercise, and resistance exercise training each have value in the management of lipedema. The effects of PR for the treatment of lipedema are variable among studies, although overall PR seems to be effective in lipedema management. Although physiotherapy applications have a potentially important role in the management of lipedema, they should be used in combination with other treatment modalities. More studies with higher quality are needed to fully demonstrate the effect and efficacy of PR in lipedema patients

Measurements of the mechanical stress induced in flip chip dies by the underfill and simulation of the underlying phenomena of thermal-mechanical and chemical reactions

The stress sensing system, which has been developed recently, allows measuring the magnitudes and the distribution of mechanical stresses induced in the silicon dies during fabrication and testing of the electronic packages. The studies already presented in the last years focused on the effects of temperature cycling, 4-point-bending, moisture swelling, and molding. This paper reports the results of the latest investigation, in which the stress sensing system has been used to explore the chemo-thermo-mechanical effects of the epoxy underfill within a typical flip chip module. In-situ readings of all 60 measuring cells of the stress chip were performed cyclically during the entire underfill process. So, it was possible to clearly distinguish between the stresses curing of the underfill at the process temperature and the stresses induced by thermal shrinkage of the epoxy during the subsequent cooling - even as functions of process and design parameters. The results to be presented in the paper reveal the enormous curing stress and its dependency on the curing temperature as well as the influences of possible voids and geometric parameters like the stand-off height between chip to board on curing and thermal stresses. Furthermore, the paper presents a comprehensive multi-physics finite element analysis (FEA) on the induced stresses and leads to a better understanding of the underfilling process. In this simulation, the diffusion expansion material parameter has been used to model the curing stress that results from the chemical reaction while the thermal mismatch is captured by the coefficient of thermal expansion as usual. This way, the two phenomena could be addressed as separately as they appear in reality. This has further improved the validity and the quantitative accuracy of the FEA results

Dogmas and controversies in compression therapy: Report of an International Compression Club (ICC) meeting, Brussels, May 2011

The International Compression Club (ICC) is a partnership between academics, clinicians and industry focused upon understanding the role of compression in the management of different clinical conditions. The ICC meet regularly and from these meetings have produced a series of eight consensus publications upon topics ranging from evidence-based compression to compression trials for arm lymphoedema. All of the current consensus documents can be accessed on the ICC website (http://www.icc-compressionclub.com/index.php). In May 2011, the ICC met in Brussels during the European Wound Management Association (EWMA) annual conference. With almost 50 members in attendance, the day-long ICC meeting challenged a series of dogmas and myths that exist when considering compression therapies. In preparation for a discussion on beliefs surrounding compression, a forum was established on the ICC website where presenters were able to display a summary of their thoughts upon each dogma to be discussed during the meeting. Members of the ICC could then provide comments on each topic thereby widening the discussion to the entire membership of the ICC rather than simply those who were attending the EWMA conference. This article presents an extended report of the issues that were discussed, with each dogma covered in a separate section. The ICC discussed 12 'dogmas' with areas 1 through 7 dedicated to materials and application techniques used to apply compression with the remaining topics (8 through 12) related to the indications for using compression. © 2012 John Wiley & Sons Ltd and Medicalhelplines.com Inc