Does the speed of aquatic therapy exercise alter arm volume in women with breast cancer related lymphoedema? A cross-over randomized controlled trial
Rosalind Deacon, Marcos de Noronha, Leah Shanley, Kaye Young. Brazilian Journal of Physical Therapy 2018
Objective: To identify whether slow aquatic exercise in the form of modified Ai Chi is more effective than conventional (faster pace) aquatic therapy at reducing arm volume in women with or at risk of breast cancer related lymphoedema.
Methods: Randomized, cross-over controlled trial with concealed allocation and blinded assessment. Eighteen women with a history of breast cancer related lymphoedema were recruited.
Participants received two intervention sessions (randomized order) with one week apart. Inter-ventions were a 50 min conventional aquatic intervention or a 50 min modified Ai Chi. Arm volume was measured as the difference between affected and unaffected arm; bio-impedance was measured as an index of extracellular fluid; satisfaction was measured via a 12 question form. Outcomes were measured before, immediately after and one hour after intervention.
Results: Comparison between interventions showed larger decreased arm volume of 140 mL (95%CI 17—263) immediately after intervention in favor of the Ai Chi intervention, however it was not sustained at 1 h follow-up. A post hoc analysis showed 72% of participants had a decrease in arm volume immediately after Ai Chi compared to 28% immediately after conventional aquatic therapy; with a number needed to treat of 3 (95%CI 1.4—6.6). There were no differences between interventions for bio-impedance. Satisfaction was good for both interventions.