Recent studies by Ahmed et al. and Schmitz et al.
reported 80 and 88 percent adherence rates to twice a week
supervised exercise programs for 6 months and 1 year,
respectively [23,25]; in our study, adherence was found to
be 89 percent. Reason for this may be that the selfdirected
exercise program for a short period of 8 weeks
included many features thought to comprise effective
home training, including baseline evaluation, written
guidelines for home exercise, education about the exercise
monitoring and self-care, daily activities log, once weekly
telephonic monitoring by the therapist, and interim evaluation
(fourth week). It may also be the fact that self-directed
exercises performed in the home and community facilities
are more convenient, and therefore, participants adhered
more to the prescribed exercise program. In our study,
none of the participants reported increased lymphedema
symptoms as a result of the exercise program