Friday, February 8, 2013

Water-Based Exercise for Patients with Chronic Arm Lymphedema: A Randomized Controlled Pilot Trial.

Water-Based Exercise for Patients with Chronic Arm Lymphedema: A Randomized Controlled Pilot Trial.

Jan  2013


From the Institution of Health Science, Department of Physiotherapy, Lund University, Lund, Sweden (KJ); School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD, Australia (SH); Department of Biostatistics and Epidemiology and Department of Anesthesiology, University of Pennsylvania, Philadelphia (RMS); and Division of Clinical Epidemiology, Department of Biostatistics and Epidemiology, and Department of Family Medicine and Community Health, University of Pennsylvania School of Medicine, Philadelphia (KHS).



The aim of this study was to evaluate the feasibility and effect of a water-based exercise program on lymphedema status and shoulder range of motion among women with breast cancer-related lymphedema.


This was a single-blinded, randomized controlled pilot trial. Twenty-nine eligible breast cancer survivors (median, 10 yrs after surgery) with arm lymphedema (median, 21% interlimb difference) were included and randomized into the intervention (n = 15) or control (n = 14) group. Twenty-five participants completed the study. The intervention was at least twice-weekly water-based exercise for 8 wks, initially supervised but performed independently during the study period. Outcomes of interest were feasibility as measured by retention and adherence; lymphedema status as measured by optoelectronic perometry, bioimpedance spectroscopy, and tissue dielectric constant; and shoulder range of motion as measured by goniometer.


 Four participants were not measured at postintervention and were not included in the analysis (retention). Four participants in the intervention group did not perform the minimum water-based exercise criteria set (adherence). No effect was found on lymphedema status. Compared with the control group, median range of motion change for flexion was 6 (1-10) degrees and 6  degrees  for external rotation.A clinically relevant increase in the intervention group was found for 36% in flexion and 57% in external rotation (P ≤ 0.05) compared with controls.


This study shows that water-based exercise is feasible for breast cancer survivors with arm lymphedema and that shoulder range of motion can be improved years after cancer treatment has been completed.

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