Nordic Walking and the Isa Method for Breast Cancer Survivors: Effects on Upper Limb Circumferences and Total Body Extracellular Water - a Pilot Study

Abstract

Background: The negative side effects of breast cancer treatments can include upper limb lymphoedema. The growing literature indicates that Nordic walking is an effective discipline against several disease symptoms. The aim of this study was to determine whether introduction to Nordic walking alone is effective against total body extracellular water and upper limb circumferences in breast cancer survivors compared to its combination with a series of specifically created exercises (i.e. the Isa method). Methods: 16 breast cancer survivors (49.09 ± 2.24 years) were recruited and randomly assigned to 1 of 2 different training groups. Results: 10 lessons on Nordic walking technique plus the Isa method significantly reduced both extracellular body water and the extracellular-to-total body water ratio (p = 0.01 for both), and also the circumference of the upper limb, (both relaxed arm and forearm circumferences) (p = 0.01 for all), whereas Nordic walking alone did not. Conclusions: Introduction to Nordic walking does not seem to affect lymphoedema in breast cancer survivors. This might be because novice Nordic Walkers do not adequately generate an effective muscular pump through coordination of the alternated bimanual open-close cycle. The Isa method appears to close this gap.

Nordic walking for women with breast cancer: A systematic review

“…The initial search resulted in the finding of 76 investigations. After reading the titles and the abstracts, 36 potential studies were identified, 9 of which were included in the final analysis (Figure ; Di Blasio, Morano, Bucci, et al, ; Di Blasio, Morano, Napolitano, et al, ; Fields, Richardson, Hopkinson, & Fenlon, ; Fischer et al, ; Hanuszkiewicz, Malicka, Barczyk‐Pawelec, & Woźniewski, ; Hanuszkiewicz, Malicka, & Woźniewski, ; Jönsson & Johansson, , ; Malicka et al, ).…”

“…The ES of the different studies is presented in Table . The study from Di Blasio, Morano, Napolitano, et al, () did not report sufficient data to calculate the ES.…”

“…A total of five investigations provided information about the effects of NW in lymphedemas (14,15,17–19 Di Blasio, Morano, Bucci, et al, ; Di Blasio, Morano, Napolitano, et al, ; Jönsson & Johansson, ; Jönsson & Johansson, ; Malicka et al, ) Four of them returned significant positive effects after the exercise programme, which was manifested in a reduction of extracellular fluid (trivial to small ES) and the circumference of the arm (trivial to large ES) (Di Blasio, Morano, Bucci, et al, ; Di Blasio, Morano, Napolitano, et al, ), as well as the lymphedema absolute volume (trivial ES) and lymphedema relative volume (trivial ES; Jönsson & Johansson, , ).…”

“…The four RCTs analysed (Di Blasio, Morano, Bucci, et al, 2016b;Di Blasio, Morano, Napolitano, et al, 2016a;Fields et al, 2016;Malicka et al, 2011) showed a fair methodological quality (Table 1), while the five quasi-experimental studies (Fischer et al, 2015;Hanuszkiewicz et al, 2015Hanuszkiewicz et al, , 2014Jönsson & Johansson, 2009) obtained a score ranging from "fair" (Fischer et al, 2015;Jönsson & Johansson, 2014) to "poor" (18) ( Table 2).…”

“…The study from Di Blasio, Morano, Napolitano, et al, (2016a) did not report sufficient data to calculate the ES.…”