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

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°C. 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.