title: Nordic Walking and the Isa Method for Breast Cancer Survivors: Effects on Upper Limb Circumferences and Total Body Extracellular Water - a Pilot Study.
abstract: BACKGROUND
  The negative side effects of breast cancer treatments can include upper limb lymphoedema. The growing literature indicates that Nordic walking is an effective discipline against several disease symptoms. The aim of this study was to determine whether introduction to Nordic walking alone is effective against total body extracellular water and upper limb circumferences in breast cancer survivors compared to its combination with a series of specifically created exercises (i.e. the Isa method).
  
  
  METHODS
  16 breast cancer survivors (49.09 ± 2.24 years) were recruited and randomly assigned to 1 of 2 different training groups.
  
  
  RESULTS
  10 lessons on Nordic walking technique plus the Isa method significantly reduced both extracellular body water and the extracellular-to-total body water ratio (p = 0.01 for both), and also the circumference of the upper limb, (both relaxed arm and forearm circumferences) (p = 0.01 for all), whereas Nordic walking alone did not.
  
  
  CONCLUSIONS
  Introduction to Nordic walking does not seem to affect lymphoedema in breast cancer survivors. This might be because novice Nordic Walkers do not adequately generate an effective muscular pump through coordination of the alternated bimanual open-close cycle. The Isa method appears to close this gap.
authors.affiliation: Department of Medicine and Aging Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti Scalo, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Blasio
authors.affiliation: Department of Medicine and Aging Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti Scalo, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Morano
authors.affiliation: Department of Medicine and Aging Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti Scalo, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Napolitano
authors.affiliation: Department of Medicine and Aging Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti Scalo, Italy.
authors.forename: Ines
authors.initials: I
authors.lastname: Bucci
authors.affiliation: Department of Medicine and Aging Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti Scalo, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Di Santo
authors.affiliation: Department of Neuroscience and Imaging, 'G. d'Annunzio' University of Chieti-Pescara, Chieti Scalo, Italy.
authors.forename: Sabina
authors.initials: S
authors.lastname: Gallina
authors.affiliation: 'M. Aresu' Department of Medical Sciences, University of Cagliari, Cagliari, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Cugusi
authors.affiliation: Dietamovimento.it Laboratories, Montesilvano, University of Chieti-Pescara, Chieti Scalo, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Donato
authors.affiliation: Sportlab, Francavilla al Mare, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: D'Arielli
authors.affiliation: Department of Medical, Oral and Biotechnological Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti Scalo, Italy.
authors.forename: Ettore
authors.initials: E
authors.lastname: Cianchetti
keywords: Foam balls; Lymphoedema; Muscular pump; Nordic walking; Physical exercise