Yoga management of breast cancer-related lymphoedema: a randomised controlled pilot-trial

Abstract

BackgroundSecondary arm lymphoedema continues to affect at least 20% of women after treatment for breast cancer requiring lifelong professional treatment and self-management. The holistic practice of yoga may offer benefits as an adjunct self-management option. The aim of this small pilot trial was to gain preliminary data to determine the effect of yoga on women with stage one breast cancer-related lymphoedema (BCRL). This paper reports the results for the primary and secondary outcomes.MethodsParticipants were randomised, after baseline testing, to receive either an 8-week yoga intervention (n = 15), consisting of a weekly 90-minute teacher-led class and a 40-minute daily session delivered by DVD, or to a usual care wait-listed control group (n = 13). Primary outcome measures were: arm volume of lymphoedema measured by circumference and extra-cellular fluid measured by bioimpedance spectroscopy. Secondary outcome measures were: tissue induration measured by tonometry; levels of sensations, pain, fatigue, and their limiting effects all measured by a visual analogue scale (VAS) and quality of life based on the Lymphoedema Quality of Life Tool (LYMQOL). Measurements were conducted at baseline, week 8 (post-intervention) and week 12 (four weeks after cessation of the intervention).ResultsAt week 8, the intervention group had a greater decrease in tissue induration of the affected upper arm compared to the control group (p = 0.050), as well as a greater reduction in the symptom sub-scale for QOL (p = 0.038). There was no difference in arm volume of lymphoedema or extra-cellular fluid between groups at week 8; however, at week 12, arm volume increased more for the intervention group than the control group (p = 0.032).ConclusionsAn 8-week yoga intervention reduced tissue induration of the affected upper arm and decreased the QOL sub-scale of symptoms. Arm volume of lymphoedema and extra-cellular fluid did not increase. These benefits did not last on cessation of the intervention when arm volume of lymphoedema increased. Further research trials with a longer duration, higher levels of lymphoedema and larger numbers are warranted before definitive conclusions can be made.

Yoga research review

“…This decreased arm volume was significant but the sample was small and this was a pre-posttest design without a control group. In another study that was a randomized controlled trial for yoga (again for 8 weeks), the yoga group had a greater decrease in tissue induration of the affected upper arm but there was no difference in arm volume/ lymphedema ( [127]. Further, at a four week follow-up period there were no longer any positive effects.…”

Post-operative exercises after breast cancer surgery: Results of a RCT evaluating standard care versus standard care plus additional yoga exercise

“…Previous observational studies in women following breast cancer surgery with or without lymphoedema demonstrated some preliminary effects in favour of the yoga intervention, but studies were not representative due to small sample sizes [19][20][21]32,33].…”

Évaluation d’un atelier « Yoga et relaxation » dans un programme d’éducation thérapeutique « Vivre avec son lymphœdème »

“…Le yoga apparaît de plus en plus dans le cadre de la prise en charge du lymphoedème, y compris dans les publications scientifiques [2,3]. Il peut être l'objet d'une évaluation à part entière [4][5][6]. Une étude récente est même contrôlée et randomisée [6].…”

“…Il peut être l'objet d'une évaluation à part entière [4][5][6]. Une étude récente est même contrôlée et randomisée [6]. L'ensemble de ces études conclut à des points positifs pour le patient dans sa prise en charge.…”