title: Yoga management of breast cancer-related lymphoedema: a randomised controlled pilot-trial.
abstract: BACKGROUND
  Secondary arm lymphoedema continues to affect at least 20% of women after treatment for breast cancer requiring lifelong professional treatment and self-management. The holistic practice of yoga may offer benefits as an adjunct self-management option. The aim of this small pilot trial was to gain preliminary data to determine the effect of yoga on women with stage one breast cancer-related lymphoedema (BCRL). This paper reports the results for the primary and secondary outcomes.
  
  
  METHODS
  Participants were randomised, after baseline testing, to receive either an 8-week yoga intervention (n = 15), consisting of a weekly 90-minute teacher-led class and a 40-minute daily session delivered by DVD, or to a usual care wait-listed control group (n = 13). Primary outcome measures were: arm volume of lymphoedema measured by circumference and extra-cellular fluid measured by bioimpedance spectroscopy. Secondary outcome measures were: tissue induration measured by tonometry; levels of sensations, pain, fatigue, and their limiting effects all measured by a visual analogue scale (VAS) and quality of life based on the Lymphoedema Quality of Life Tool (LYMQOL). Measurements were conducted at baseline, week 8 (post-intervention) and week 12 (four weeks after cessation of the intervention).
  
  
  RESULTS
  At week 8, the intervention group had a greater decrease in tissue induration of the affected upper arm compared to the control group (p = 0.050), as well as a greater reduction in the symptom sub-scale for QOL (p = 0.038). There was no difference in arm volume of lymphoedema or extra-cellular fluid between groups at week 8; however, at week 12, arm volume increased more for the intervention group than the control group (p = 0.032).
  
  
  CONCLUSIONS
  An 8-week yoga intervention reduced tissue induration of the affected upper arm and decreased the QOL sub-scale of symptoms. Arm volume of lymphoedema and extra-cellular fluid did not increase. These benefits did not last on cessation of the intervention when arm volume of lymphoedema increased. Further research trials with a longer duration, higher levels of lymphoedema and larger numbers are warranted before definitive conclusions can be made.
authors: Annette
authors: A
authors: Loudon
authors: Tony
authors: T
authors: Barnett
authors: Neil
authors: N
authors: Piller
authors: Maarten A
authors: MA
authors: Immink
authors: School of Health Sciences, University of Tasmania, Launceston, Australia. Andrew.Williams@utas.edu.au.
authors: Andrew D
authors: AD
authors: Williams
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000473:pathology* / Q000628:therapy*; D008875:Middle Aged; D010147:Pain Measurement; D010865:Pilot Projects; D011788:Quality of Life; D012648:Self Care; D015013:Yoga