title: Water versus land-based multimodal exercise program effects on body composition in breast cancer survivors: a controlled clinical trial.
abstract: OBJECTIVE
  Our aim was to compare the effects of land versus water multimodal exercise programs on body composition and breast cancer-specific quality of life in breast cancer survivors.
  
  
  METHODS
  Ninety-eight breast cancer survivors were assigned to three groups: control, land exercise, and water exercise. Both exercise groups participated in an 8-week multimodal program. Adiposity was measured by anthropometry (body mass index, waist circumference) and bioelectrical impedance (body fat and muscle lean body mass). Incidence of clinically significant secondary lymphedema was also assessed. Finally, specific quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life BR-23.
  
  
  RESULTS
  Using ANCOVA, significant group × time interactions for body fat percentage (F = 3.376; P = 0.011) and lean body mass (F = 3.566; P = 0.008) were found. Breast cancer survivors in the land exercise group exhibited a greater decrease in percentage of body fat than those in the water exercise (P < 0.001) and control (P = 0.002) groups. The ANCOVA revealed a significant group × time interaction for waist circumference (F = 4.553; P = 0.002): breast cancer survivors in the control group showed a greater waist circumference when compared to water (P = 0.003) and land (P < 0.001) exercise groups. A significant group × time interaction was also found for breast symptoms (F = 9.048; P < 0.001): participants in the water exercise group experienced a greater decrease of breast symptoms than those in the land exercise (P < 0.01) and control (P < 0.05) groups.
  
  
  CONCLUSIONS
  Land exercise produced a greater decrease in body fat and an increase in lean body mass, whereas water exercise was better for improving breast symptoms.
authors.affiliation: Department of Physical Therapy, Health Sciences Faculty, Universidad de Granada, Avenida de Madrid s/n, 18071, Granada, Spain.
authors.forename: Carolina
authors.initials: C
authors.lastname: Fernández-Lao
authors.forename: Irene
authors.initials: I
authors.lastname: Cantarero-Villanueva
authors.forename: Angelica
authors.initials: A
authors.lastname: Ariza-Garcia
authors.forename: Carol
authors.initials: C
authors.lastname: Courtney
authors.forename: César
authors.initials: C
authors.lastname: Fernández-de-las-Peñas
authors.forename: Manuel
authors.initials: M
authors.lastname: Arroyo-Morales
mesh_terms: D000704:Analysis of Variance; D001823:Body Composition; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D020446:Fitness Centers; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D013030:Spain; D017741:Survivors; D013551:Swimming Pools; D055105:Waist Circumference