title: Aqua lymphatic therapy in women who suffer from breast cancer treatment-related lymphedema: a randomized controlled study.
abstract: BACKGROUND
  Lymphedema is an adverse effect of breast cancer surgery. Aqua lymphatic therapy (ALT) is a novel treatment for limb volume reduction.
  
  
  OBJECTIVE
  The aim of this study was to examine whether ALT is a safe method and whether there are differences in adherence, limb volume, and quality of life between women who perform only self-management treatment and women who participate as well in ALT.
  
  
  METHODS
  Design of the study was single-blind randomized clinical trial.
  
  
  METHODS
  The setting was in a hydrotherapy pool, 1.2 m depth, and a temperature of 32-33 degrees capital ES, Cyrillic.
  
  
  METHODS
  Forty-eight women (56 +/- 10 years), with a 12.8% lymphedema relative volume, participated in the study.
  
  
  METHODS
  The control group was instructed to perform the self-management treatment. The study group joined a weekly session of ALT for 3 months in addition to the self-management therapy.
  
  
  METHODS
  Adherence was assessed by a self-reported diary, limb volume by a water displacement device, quality of life by the Upper Limb Lymphedema Questionnaire (ULL27), prior to, and after the intervention period.
  
  
  RESULTS
  There was no episode of arm infection or aggravation in limb volume during the study period. ALT had a positive, statistically and clinically significant immediate effect on limb volume but no long-term effect was noted. The adherence rate to ALT was significantly higher than the adherence to self-management therapy. QOL improved in the study group.
  
  
  CONCLUSIONS
  ALT was found to be a safe method, with high adherence, in treating women who suffer from mild to moderate lymphedema. A significant immediate and insignificant long-term effect on limb volume was noted.
authors.affiliation: Department of Physical Therapy, "Maccabi Healthcare Services", Netivot, Israel.
authors.forename: Dorit
authors.initials: D
authors.lastname: Tidhar
authors.forename: Michal
authors.initials: M
authors.lastname: Katz-Leurer
mesh_terms: D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D006875:Hydrotherapy / Q000379:methods*; D008197:Lymph Node Excision / Q000009:adverse effects*; D008209:Lymphedema / Q000209:etiology / Q000628:therapy*; D008405:Massage / Q000379:methods; D008875:Middle Aged; D010349:Patient Compliance; D017060:Patient Satisfaction; D011159:Population Surveillance; D011788:Quality of Life; D012648:Self Care; D011795:Surveys and Questionnaires; D016896:Treatment Outcome