Effect of Aqua Therapy Exercises on Postmastectomy Lymphedema: A Prospective Randomized Controlled Trial

Abstract

Objective To investigate the effect of aqua therapy resistance exercise on arm volume, pain, and shoulder range of movements in post-mastectomy lymphedema.Methods This was a single-blind randomized controlled trial. Fifty eligible breast cancer survivors (median, 10 years after surgery) with lymphedema (median, 21% inter-limb difference) were assigned randomly to group A (n=25) or control group B (n=25). The study group underwent 60 minutes of aqua therapy exercise comprising of warm-up for 10 minutes, 40 minutes of strengthening exercises, and 10 minutes of cooling down, three times a week for 8 weeks. The control group underwent 60 minutes of land-based exercise three times a week for 8 weeks. Arm volume calculated by measuring the arm circumference, shoulder flexion, and abduction range of motion (ROM), and pain using a visual analog scale (VAS) were assessed at baseline and after 8 weeks of treatment.Results There was a statistically significant difference in limb volume, shoulder flexion and abduction ROM, and VAS scores in favor of the study group (p<0.001) after 8 weeks of intervention. The mean±standard deviation for limb volume, shoulder flexion, abduction, and pain score were 2,108.71±200.97 mL, 169.68°±4.54°, 150.44°±3.92°, and 3.16±1.1 in the study group and 2,256.41±186.94 mL, 147.36°±5.32°, 131.32°±4.38°, and 5.68±0.94 in the control group, respectively.Conclusion Adding aqua therapy resistance exercise to routine physical therapy might be more effective in decreasing the limb volume and pain intensity and improving ROM of the shoulder in postmastectomy lymphedema.

Physical activity and pain in people with cancer: a systematic review and meta-analysis

“…From 4171 records first identified, 3566 titles and abstracts and 504 full texts screened, there were 132 publications from 121 studies included in the final review. Studies included 102 RCTs [ 1 , 2 , 4 , 6 – 12 , 15 , 16 , 18 , 19 , 21 – 24 , 26 , 29 – 32 , 35 , 37 , 38 , 40 , 41 , 45 – 52 , 55 , 57 , 61 – 63 , 65 , 67 – 72 , 75 – 81 , 83 , 84 , 86 – 88 , 91 – 99 , 101 , 103 – 106 , 109 , 110 , 112 – 114 , 116 , 118 – 122 , 124 – 127 , 129 , 130 , 132 , 133 , 136 – 140 , 143 , 145 , 146 , 149 – 151 , 153 – 157 ], six randomised RXTs [ 17 , 34 , 36 , 39 , 142 , 152 ], and 13 ob...…”

“…Some studies showed no difference in effect for type [ 80 , 88 , 106 , 152 , 153 , 156 ], while others showed larger effects of aerobic exercise compared to resistance [ 40 , 63 , 129 ], or for resistance and high intensity interval training compared to aerobic exercise combined with high intensity interval training [ 19 , 113 ]. In other studies, aquatic exercises may have been more effective than land exercises [ 4 ], and Pilates more effective than circuit exercises [ 11 ].…”

Does aquatic physical therapy affect the rehabilitation of breast cancer in women? A systematic review and meta-analysis of randomized controlled trials

“…In addition, studies have shown that aquatic physical therapy not only reduces the lymphedema risk in those with breast cancer [ 17 ], but also relieves persistent skin dryness caused by cancer treatment and significantly decreases the incidence of skin induration, thereby potentially decreasing chances of cancer recurrence [ 18 ]. Meanwhile, it provides a safe, effective and non-invasive method for the treatment of breast cancer survivors, and avoids invasive methods and oral medications that cannot be tolerated over a long period due to their adverse systemic effects [ 19 ]. In light of this, aquatic physical therapy would be an ideal form of physical rehabilitation for patients with breast cancer.…”