The Effectiveness of the Sport Dragon Boat Racing in Reducing the Risk of Lymphedema Incidence: An Observational Study

Iacorossi L, Gambalunga F, Molinaro S, De Domenico R, Giannarelli D, Fabi A. Cancer Nurs. 2018 June 22

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The Effectiveness of the Sport “Dragon Boat Racing” in Reducing the Risk of Lymphedema Incidence: An Observational Study

Iacorossi L, Gambalunga F, Molinaro S, De Domenico R, Giannarelli D, Fabi A.  Cancer Nurs. 2018 June 22

BACKGROUND:

Upper extremity lymphedema is a complication that often occurs in women with breast cancer as a result of surgery and/or radiotherapy. Some studies report that a boating activity known as the “dragon boat” sport can benefit these women.

AIM:

The aim of this study was to assess whether this type of sport prevents or reduces lymphedema, its impact on quality of life (QoL), and the possible predictors of this condition.

METHODS:

This was an observational study of 2 groups: group A (women who participated in dragon boat racing for at least 6 months) and group B (women who participated in other forms of physical exercise biweekly). Data were collected at the National Cancer Institute of Rome and the lake of Castel Gandolfo from June to October 2016. The instruments used were a questionnaire created for sociodemographic and clinical data, the European Organisation for Research and Treatment of Cancer Core Questionnaire for evaluating QoL, and a tape measure applied to estimate the local lymphedema.

RESULTS:

One hundred women participated in the study. Lymphedema incidence in group A was 4.0% (2 of 50), whereas in group B it was 26.0% (13 of 50). Women who participated in dragon boat racing also reported a healthier lifestyle, lower body mass index, and a better QoL (set point: 61.8 group B vs 80.0 group A).

CONCLUSIONS:

The dragon boat sport participants had more positive clinical and QoL outcomes than did the women who did not participate in that sporting activity.

IMPLICATIONS FOR CLINICAL PRACTICE:

It would be important to make women with breast cancer aware of the practice of dragon boat racing.

Main findings

  • Women consider participation in the dragon boat sport as an opportunity

(a) for social support and personal control,

(b) to develop interpersonal relationships with people facing the same situation, and

(c) to create a new identity (from patient to athlete), indispensable to overcoming the physical challenges associated with oncological disease and its treatments.

  • One hundred breast cancer survivors were selected; 50 women of group A and 50 women of group B were selected in consecutive days. The majority of them are married, with 1 or 2 children, and employed. The women in group A have a medium to high level of education (52.0% group A vs 24.0% group B), are younger in age (14.0% group A vs 46.0% group B), and have a lower BMI (PG.0001).
  • Most women included in group B had alternative therapies such as compression therapy (36.0%) and lymphatic drainage (28.0%), whereas fewer practiced sports such as pilates, yoga, tai-chi (20.0%), or jogging or walking (16.0%).
  • There was marked improvement in the degree of lymphedema in group A women; a better quality of life (PG.0001); a reduction in symptoms such as fatigue (P=.02), insomnia (P=.001), and dyspnea (P=.03); and a significant reduction in physical-related disorders (PG.0001), emotional (P=.001), cognitive (P=.01), and relational/role (P=.005).
  • The limitations of the study are definitely related to the small and monocentric sample and to group B that was not matched. Furthermore, if the tape measure is too large or too tight on the skin, it can lead to bias. Further studies are needed in the future to widen the survey into a numerically larger sample and multicentric study, so as to make the results generalizable over an entire population and have more accurate estimates of the impact of the dragon boat sport on the overall recovery of patients with breast cancer and lymphedema.