A comparison of three intervention methods for women with breast cancer-related lymphedema: a pilot study

The incidence of breast cancer related lymphedema (BCRL) is estimated to be at 30% for women who undergo breast cancer treatment, thus creating the need for effective treatment interventions. This thesis will compare the immediate and short-term effects of three different interventions for BCRL (e.g., Manual Lymphatic Drainage (MLD), Aqua Lymphatic Therapy (ALT), and a Casley-Smith based exercise routine (CSER)) and to record any changes in physical symptoms after each intervention. Sixteen women between the ages of 35 and 75 with Stage II lymphedema were recruited. Each intervention was completed once by each participant and lasted approximately 45 minutes. Bilateral limb measurements to estimate changes in volume were performed using bio-impedance spectroscopy and circumferential arm measures. The Lymphedema Breast Cancer Questionnaire was utilized to subjectively gauge any change in symptoms. The main findings were: ALT was the only intervention that showed a significant (p≤0.05) decrease in extracellular fluid (ECF) from baseline to 20-24hrs post-intervention. When compared to the MLD, the ALT intervention demonstrated a 3.31% greater (p=0.038) reduction in ECF volume over 24hrs. With respect to circumferential arm measurements, there was a significant difference (p=0.021) in the percentage change between ALT and MLD at 10 min post intervention. No other circumferential arm measurement differences exist between ALT vs CSER or MLD vs CSER. There were no changes or any worsening symptoms following any interventions. Conclusion: In the immediate to short-term post-intervention period, ALT appears to be the most effective intervention in terms of reducing BCRL