title: Breast cancer-related lymphedema: a randomized controlled pilot and feasibility study.
abstract: OBJECTIVE
  Chronic lymphedema occurs frequently in breast cancer patients and is associated with significant morbidity and reduced quality-of-life. In this pilot study, the authors (1) addressed whether conducting a larger randomized controlled trial of aqua lymphatic therapy (ALT) would be feasible and (2) estimated the extent to which ALT combined with home-based exercise compared with home-based exercise alone would reduce arm disability in patients with breast cancer-related lymphedema.
  
  
  METHODS
  Twenty-five women with breast cancer-related lymphedema were randomized to either ALT in addition to a home land-based exercise program (ALT group; n = 13) or to a home land-based exercise program alone (control group; n = 12). The participants were evaluated before and after a 12-wk intervention period composed of weekly pool exercise sessions. Main outcome measures were arm volume, arm disability, pain, and quality-of-life.
  
  
  RESULTS
  At follow-up, there was no statistical difference between the control and ALT groups in any of the outcomes, except for present pain intensity. At the end of the study period, there was no change in the lymphedematous limb volume in either group. Grip strength was improved in both groups. Only the ALT group showed a statistically significant difference with a reduction in pain intensity score and arm disability. Furthermore, quality-of-life significantly improved only in the ALT group.
  
  
  CONCLUSIONS
  Conducting a larger randomized controlled trial would be feasible. In comparison with the beginning of the intervention, the participants in the ALT group showed significant beneficial changes after 12 wks of treatment, whereas the control group did not improve. ALT did not make the lymphedema volume worse and therefore may serve as a safe alternative to land-based treatments of breast cancer-related lymphedema.
authors.affiliation: From the School of Physical and Occupational Therapy (M-EL) and Department of Oncology (AT), McGill University, Montreal, Quebec, Canada; Department of Cardiology, Soroka University Medical Center, Ben Gurion University, Be'er Sheba, Israel (AS); and Department of Physical Therapy, Maccabi Healthcare Services, Sderot, Israel (DT).
authors.forename: Marie-Eve
authors.initials: ME
authors.lastname: Letellier
authors.forename: Anna
authors.initials: A
authors.lastname: Towers
authors.forename: Avi
authors.initials: A
authors.lastname: Shimony
authors.forename: Dorit
authors.initials: D
authors.lastname: Tidhar
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000150:complications* / Q000601:surgery; D005081:Exercise Therapy; D005240:Feasibility Studies; D005260:Female; D018737:Hand Strength; D006801:Humans; D006875:Hydrotherapy / Q000379:methods*; D008209:Lymphedema / Q000209:etiology*; D008875:Middle Aged; D052580:Muscle Stretching Exercises; D010865:Pilot Projects; D011788:Quality of Life; D016037:Single-Blind Method; D016896:Treatment Outcome