Water-Based Exercise for Patients with Chronic Arm Lymphedema: A Randomized Controlled Pilot Trial.
Jan 2013
Source
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).
Abstract
OBJECTIVE:
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.
DESIGN:
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.
RESULTS:
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.
CONCLUSIONS:
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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