Water-based exercise for patients with chronic arm lymphedema: a randomized controlled pilot trial.
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.


METHODS
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 (P < 0.001) and 6 (0-15.5) degrees (P = 0.07) for external rotation.A clinically relevant increase in the intervention group was found for 36% in flexion (P ≤ 0.05) 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.
Institution of Health Science, Department of Physiotherapy, Lund University, Lund, Sweden.
Karin
K
Johansson
Sandi
S
Hayes
Rebecca M
RM
Speck
Kathryn H
KH
Schmitz
D000368:Aged; D001943:Breast Neoplasms / Q000150:complications; D002908:Chronic Disease; D005081:Exercise Therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D008875:Middle Aged; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000503:physiopathology; D016037:Single-Blind Method