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Supportive Care in Cancer

Published in:

01-03-2010 | Original Article

Aqua lymphatic therapy in women who suffer from breast cancer treatment-related lymphedema: a randomized controlled study

Authors: Dorit Tidhar, Michal Katz-Leurer

Published in: Supportive Care in Cancer | Issue 3/2010

Abstract

Background

Lymphedema is an adverse effect of breast cancer surgery. Aqua lymphatic therapy (ALT) is a novel treatment for limb volume reduction.

Objective

The aim of this study was to examine whether ALT is a safe method and whether there are differences in adherence, limb volume, and quality of life between women who perform only self-management treatment and women who participate as well in ALT.

Design

Design of the study was single-blind randomized clinical trial.

Setting

The setting was in a hydrotherapy pool, 1.2 m depth, and a temperature of 32–33°С.

Patients

Forty-eight women (56 ± 10 years), with a 12.8% lymphedema relative volume, participated in the study.

Intervention

The control group was instructed to perform the self-management treatment. The study group joined a weekly session of ALT for 3 months in addition to the self-management therapy.

Measurements

Adherence was assessed by a self-reported diary, limb volume by a water displacement device, quality of life by the Upper Limb Lymphedema Questionnaire (ULL27), prior to, and after the intervention period.

Results

There was no episode of arm infection or aggravation in limb volume during the study period. ALT had a positive, statistically and clinically significant immediate effect on limb volume but no long-term effect was noted. The adherence rate to ALT was significantly higher than the adherence to self-management therapy. QOL improved in the study group.

Conclusion

ALT was found to be a safe method, with high adherence, in treating women who suffer from mild to moderate lymphedema. A significant immediate and insignificant long-term effect on limb volume was noted.

Erickson VS, Pearson ML, Ganz PA (2001) Arm edema in breast cancer patients. J Natl Cancer Inst 93:96–111. doi:10.1093/jnci/93.2.96 CrossRefPubMed

Petrek J, Pressman P (2000) Lymphedema: current issues in research and management. CA Cancer J Clin 50:292–307CrossRefPubMed

Duff M, Hill AD, McGreal G (2001) Prospective evaluation of the morbidity of axillary clearance for breast cancer. Br J Surg 88:114–117. doi:10.1046/j.1365-2168.2001.01620.x CrossRefPubMed

Lymphoedema Framework (2006) Best practice for the management of lymphoedema. International consensus. MEP, London

Golshan M, Smith B (2006) Prevention and management of arm lymphedema in the patient with breast cancer. J Support Oncol 4:381–386PubMed

Box RC, Reul-Hirche HM, Bullock-Saxton JE (2002) Shoulder movement after breast cancer surgery: results of a randomised controlled study of postoperative physiotherapy. Breast Cancer Res Treat 75:35–50. doi:10.1023/A:1016571204924 CrossRefPubMed

Meeske KA (2008) Risk factors for arm lymphedema following breast cancer diagnosis in black women and white women. Breast Cancer Res Treat 113:383–391CrossRefPubMed

Soran A (2006) Breast cancer-related lymphedema—what are the significant predictors and how they affect the severity of lymphedema? Breast J 12:536–543. doi:10.1111/j.1524-4741.2006.00342.x CrossRefPubMed

International Society of Lymphology (2003) The diagnosis and treatment of peripheral lymphedema. Consensus document of the International Society of Lymphology. Lymphology 36:84–91

10.

Passik SD, McDonald MV (1998) Psychosocial aspects of upper extremity lymphedema in women treated for breast carcinoma. Cancer 83(Suppl):2817–2820. doi:10.1002/(SICI)1097-0142(19981215)83:12B+<2817::AID-CNCR32>3.0.CO;2-2 CrossRefPubMed

11.

Casley-Smith JR, Casley Smith JR (1997) Modern treatment for lymphedema, 5th edn. The Lymphology Association of Australia, Adelaide Chapters 17, 21, 45

12.

Moseley L, Carati CJ, Piller NB (2006) A systematic review of common conservative therapies for arm lymphoedema secondary to breast cancer treatment. Ann Oncol 18:639–646. doi:10.1093/annonc/mdl182 CrossRefPubMed

13.

Vignes S, Porcher R (2007) Long-term management of breast cancer-related lymphedema after intensive decongestive physiotherapy. Breast Cancer Res Treat 101:285–290. doi:10.1007/s10549-006-9297-6 CrossRefPubMed

14.

Boris M, Weindorf S, Lasinski B (1997) Persistence of lymphedema reduction after noninvasive complex lymphedema therapy. Oncology (Huntingt) 11:99–109; discussion 110, 113–114

15.

Johansson K, Piller N (2007) Weight-bearing exercise and its impact on arm lymphedema. J Lymphoedema 2:15–18

16.

Piller NB, Moseley AL, Carati CJ (2005) The effect of gentle arm exercise and deep breathing on secondary arm lymphedema. Lymphology 38:136–145PubMed

17.

Ahmed RL, Thomas W, Yee D (2006) Randomized controlled trial of weight training and lymphedema in breast cancer survivors. J Clin Oncol 24:2765–2772. doi:10.1200/JCO.2005.03.6749 CrossRefPubMed

18.

Harris SR, Niesen-Vertommen SL (2000) Challenging the myth of exercise-induced lymphedema following breast cancer: a series of case reports. J Surg Oncol 74:95–98. doi:10.1002/1096-9098(200006)74:2<95::AID-JSO3>3.0.CO;2-Q CrossRefPubMed

19.

Johansson K, Tibe K, Weibull A, Newton RC (2005) Low intensity resistance exercise for breast cancer patients with arm lymphedema with or without compression sleeve. Lymphology 38:167–180PubMed

20.

Johansson K, Tibe K, Kanne L, Skantz H (2004) Controlled physical training for arm lymphedema patients. Lymphology 37(suppl):37–39

21.

Tidhar D, Shimony A, Drouin J (2004) Aqua lymphatic therapy for postsurgical breast cancer lymphedema. Rehab Oncol 22:6–14

22.

Boris M, Lasinski B (1994) Lymphedema reduction by noninvasive complex lymphedema therapy. Oncology 8:95–106PubMed

23.

Boris M, Weindorf S, Lasinkski B (1997) Persistence of lymphedema reduction after noninvasive complex lymphedema therapy. Oncology 11:99–109PubMed

24.

Lasinski B, Boris M (2002) Comprehensive lymphedema: management results of a 5 year follow-up. Lymphology 35(suppl):301–304

25.

Megens AM, Harris SR (2001) Measurement of upper extremity volume in women after axillary dissection for breast cancer. Arch Phys Med Rehabil 82:1639–1644.CrossRefPubMed

26.

Karges JR, Mark BE, Stikeleather SJ, Worrell TW (2003) Concurrent validity of upper-extremity volume estimates: comparison of calculated volume derived from girth measurements and water displacement volume. Phys Ther 83:134–145PubMed

27.

Launois R, Mègnigbêto AC, Pocquet K, Alliot F (2002) A specific quality of life scale in upper limb lymphedema : the ULL-27 questionnaire. Lymphology 35(Suppl):181–187

28.

SPSS (1999) Statistical Program for the Social Sciences Version 9.0. SPSS, Chicago, IL

29.

Bonnetblanc JM, Bédane C (2003) Erysipelas: recognition and management. Am J Clin Dermatol 4:157–163. doi:10.2165/00128071-200304030-00002 CrossRefPubMed

30.

Papadopoulou C, Economou V (2008) Microbiological quality of indoor and outdoor swimming pools in Greece: investigation of the antibiotic resistance of the bacterial isolates. Int J Hyg Environ Health 211:385–397. doi:10.1016/j.ijheh.2007.06.007 CrossRefPubMed

31.

Angenent LT, Kelley ST, St Amand A, Pace NR, Hernandez MT (2005) Molecular identification of potential pathogens in water and air of a hospital therapy pool. Proc Natl Acad Sci U S A 102:4860–4865. doi:10.1073/pnas.0501235102 CrossRefPubMed

32.

McKenzie DC, Kalda AL (2003) Effect of upper extremity exercise on secondary lymphedema in breast cancer patients: a pilot study. J Clin Oncol 21:463–466. doi:10.1200/JCO.2003.04.069 CrossRefPubMed

33.

Ko DS, Lerner R, Klose G, Cosimi AB (1998) Effective treatment of lymphedema of the extremities. Arch Surg 133:452–458. doi:10.1001/archsurg.133.4.452 CrossRefPubMed

34.

Donovan JL, Blake DR (1992) Patient non-compliance: deviance or reasoned decision-making? Soc Sci Med 34:507–513. doi:10.1016/0277-9536(92)90206-6 CrossRefPubMed

35.

Campbell R, Evans M, Tucker M, Quilty B, Dieppe P, Donovan JL (2001) Why don't patients do their exercises? Understanding non-compliance with physiotherapy in patients with osteoarthritis of the knee. J Epidemiol Community Health 55:132–138CrossRefPubMed

36.

Ramos SM, O'Donnell LS, Knight G (1999) Edema volume, not timing, is the key to success in lymphedema treatment. Am J Surg 178:311–315. doi:10.1016/S0002-9610(99)00185-3 CrossRefPubMed

37.

Woo J, Chan W, Yeung F (2006) A community model of group therapy for the older patients with chronic obstructive pulmonary disease: a pilot study. J Eval Clin Pract 12:523–531. doi:10.1111/j.1365-2753.2006.00651.x CrossRefPubMed

38.

Sirois FM, Gick ML (2002) An investigation of the health beliefs and motivations of complementary medicine clients. Soc Sci Med 55:1025–1037. doi:10.1016/S0277-9536(01)00229-5 CrossRefPubMed

39.

Floyer-Lea A, Matthews PM (2005) Distinguishable brain activation networks for short- and long-term motor skill learning. J Neurophysiol 94:512–518. doi:10.1152/jn.00717.2004 CrossRefPubMed

40.

Mondry TE, Riffenburgh RH, Johnstone PA (2004) Prospective trial of complete decongestive therapy for upper extremity lymphedema after breast cancer therapy. Cancer J 10:42–48. doi:10.1097/00130404-200401000-00009 CrossRefPubMed

41.

Penson RT, Partridge RA, Rudd P (2005) Laughter: the best medicine? Oncologist 10:651–660. doi:10.1634/theoncologist.10-8-651 CrossRefPubMed

Title: Aqua lymphatic therapy in women who suffer from breast cancer treatment-related lymphedema: a randomized controlled study
Authors: Dorit Tidhar
Michal Katz-Leurer
Publication date: 01-03-2010
Publisher: Springer-Verlag
Published in: Supportive Care in Cancer / Issue 3/2010
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-009-0669-4

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Abstract

Background

Objective

Design

Setting

Patients

Intervention

Measurements

Results

Conclusion

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