title: The effectiveness of a deep water aquatic exercise program in cancer-related fatigue in breast cancer survivors: a randomized controlled trial.
abstract: OBJECTIVE
  To investigate the effectiveness of an 8-week aquatic program on cancer-related fatigue, as well as physical and psychological outcomes in breast cancer survivors.
  
  
  METHODS
  A randomized controlled trial.
  
  
  METHODS
  Outpatient clinic, urban, academic medical center, and a sport university swimming pool.
  
  
  METHODS
  Breast cancer survivors (N=68) were randomly assigned to either an experimental (aquatic exercise group in deep water pool) group or a control (usual care) group.
  
  
  METHODS
  The intervention group attended aquatic exercise sessions 3 times per week for 8 weeks in a heated deep swimming pool. Sessions lasted 60 minutes in duration: 10 minutes of warm-up, 40 minutes of aerobic and endurance exercises, and 10 minutes of cool-down exercises. Patients allocated to the usual care group followed the oncologist's recommendations in relation to a healthy lifestyle.
  
  
  METHODS
  Values for fatigue (Piper Fatigue Scale), mood state (Profile of Mood States), and abdominal (trunk curl static endurance test) and leg (multiple sit-to-stand test) strength were collected at baseline, after the last treatment session, and at a 6-month follow-up.
  
  
  RESULTS
  Immediately after discharge, the aquatic exercise group showed a large effect size in total fatigue score (d=.87; 95% confidence interval, .48-1.26), trunk curl endurance (d=.92; 95% confidence interval, 1.97-3.83), and leg strength (d=1.10; .55-2.76), but negligible effects in vigor, confusion, and disturbance of mood (d<.25). At the 6-month follow-up period, the aquatic exercise group maintained large to small effect sizes in fatigue scores, multiple sit-to-stand test, and trunk curl static endurance (.25>d>.90) and negligible effects for the fatigue-severity dimension and different scales of the Profile of Mood States (d<.25).
  
  
  CONCLUSIONS
  An aquatic exercise program conducted in deep water was effective for improving cancer-related fatigue and strength in breast cancer survivors.
authors.affiliation: Physical Therapy Department, University of Granada, Granada, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Cantarero-Villanueva
authors.forename: Carolina
authors.initials: C
authors.lastname: Fernández-Lao
authors.forename: Antonio I
authors.initials: AI
authors.lastname: Cuesta-Vargas
authors.forename: Rosario
authors.initials: R
authors.lastname: Del Moral-Avila
authors.forename: César
authors.initials: C
authors.lastname: Fernández-de-Las-Peñas
authors.forename: Manuel
authors.initials: M
authors.lastname: Arroyo-Morales
mesh_terms: D000009:Abdominal Muscles; D000339:Affect; D001943:Breast Neoplasms / Q000150:complications*; D015444:Exercise; D005221:Fatigue / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D053580:Muscle Strength; D010807:Physical Endurance; D017741:Survivors; D013551:Swimming Pools