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Vol. 23. Issue 2.
Pages 140-147 (01 March 2019)
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Vol. 23. Issue 2.
Pages 140-147 (01 March 2019)
Original Research
DOI: 10.1016/j.bjpt.2018.11.004
Does the speed of aquatic therapy exercise alter arm volume in women with breast cancer related lymphoedema? A cross-over randomized controlled trial
Rosalind Deacona, Marcos de Noronhab,
Corresponding author

Corresponding author at: La Trobe Rural Health School, PO Box 199, Bendigo, Victoria 3552, Australia.
, Leah Shanleya, Kaye Younga
a Bendigo Health, Bendigo, Australia
b La Trobe University, Rural Health School, Bendigo, Australia

  • Ai Chi can be used to treat arm volume for breast cancer related lymphoedema.

  • For the circumstances seen here, the main effect of Ai Chi is in the short term.

  • After 1h, the effect of Ai Chi was similar to conventional aquatic therapy.

  • Participants were satisfied with both, Ai Chi and conventional aquatic therapy.

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Table 1. Participants characteristics.
Table 2. Primary outcomes – arm volume (mL) and bio-impedance. Comparison between LSAE and CAE. Arm volume was calculated as the difference between the affected and unaffected side. Bioimpedance was measured as an index of extracellular fluid.
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To identify whether slow aquatic exercise in the form of modified Ai Chi is more effective than conventional (faster pace) aquatic therapy at reducing arm volume in women with or at risk of breast cancer related lymphoedema.


Randomized, cross-over controlled trial with concealed allocation and blinded assessment. Eighteen women with a history of breast cancer related lymphoedema were recruited. Participants received two intervention sessions (randomized order) with one week apart. Interventions were a 50min conventional aquatic intervention or a 50min modified Ai Chi. Arm volume was measured as the difference between affected and unaffected arm; bio-impedance was measured as an index of extracellular fluid; satisfaction was measured via a 12 question form. Outcomes were measured before, immediately after and one hour after intervention.


Comparison between interventions showed larger decreased arm volume of 140mL (95%CI 17–263) immediately after intervention in favor of the Ai Chi intervention, however it was not sustained at 1h follow-up. A post hoc analysis showed 72% of participants had a decrease in arm volume immediately after Ai Chi compared to 28% immediately after conventional aquatic therapy; with a number needed to treat of 3 (95%CI 1.4–6.6). There were no differences between interventions for bio-impedance. Satisfaction was good for both interventions.


Slow pace aquatic exercise is more effective than conventional aquatic exercise immediately after intervention for arm volume. Also, undesirable increase in arm volume seems to subside after 1h, which can be beneficial if therapy does not address arm volume.

Trial registration: ACTRN12614000557639 (

Ai Chi
aquatic exercise
Physical therapy


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