Progressive resistance training to prevent arm lymphedema in the first year after breast cancer surgery: Results of a randomized controlled trial

Abstract

Background Existing research suggests that progressive resistance training (PRT) after breast cancer (BC) surgery is safe, but the preventive effect on arm lymphedema has yet to be determined. Methods Women aged 18 to 75 years who were undergoing BC surgery with axillary lymph node dissection were eligible for the study. Recruited on the day of surgery, participants were allocated to intervention or usual care by computer randomization. The intervention consisted of PRT 3 times per week: in the first 20 weeks as a supervised group exercise and in the last 30 weeks as a self‐administered exercise. The primary outcome was arm lymphedema, which was defined as a >3% increase in the interlimb volume difference by water displacement. Measurements were made at the baseline and at a 12‐month follow‐up by physiotherapists blinded to group allocation. Analyses of effects included t tests and regression models; missing data were addressed by multiple imputation. Results Among the 158 randomized women, no mean group difference was found in arm volume (0.3%; 95% confidence interval, –1.7% to 2.3%) or lymphedema incidence (adjusted odds ratio, 1.2; 95% confidence interval, 0.5‐2.8). None of the participants exited the program because of adverse events. Conclusions This study provides no evidence that PRT can prevent arm lymphedema in the first year after BC, but the results corroborate the importance and safety of resistance training for patients, including women at high risk for lymphedema.

Resistance Training in Breast Cancer Survivors: A Systematic Review of Exercise Programs

“…Finally, 41 articles that met the selection criteria were selected ( Figure 1 ). These 41 articles were derived from a total of 16 trials ( Table 4 ) [ 7 , 8 , 10 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 ]. The BEATE study [ 26 , 27 ] and the BEST study [ 8 , 28 , 29 , 30 ] were treated as a single trial in the present review because they shared the same training program.…”

Interventions for Breast Cancer–Related Lymphedema: Clinical Practice Guideline From the Academy of Oncologic Physical Therapy of APTA

“…The authors described a reduced risk in a subgroup of women who had 5 of more lymph nodes removed with weightlifting. 29 Ammitzbøll et al 30 (I) reported that progressive resistance exercise is safe for women in the first year following breast cancer surgery. Women initiated supervised exercises at 3 weeks postsurgery for 20 weeks, followed by 30 weeks of self-administered resistance exercises.…”

“…There were no adverse events or mean group differences in arm volume (0.3%). 30 In both studies, 29 , 30 exercises were supervised by professionals with knowledge of complications from surgery and cancer-related treatments. Exercises were gradually increased to enhance muscle strength and endurance.…”

LENFÖDEM ve BAKIMINDA HEMŞİRE DENEYİMİ: LENFÖDEM ÜZERİNE BİR İNCELEME

“…Tedavinin etkili olabilmesi adına erken teşhis oldukça önem arz etmektedir. Klinisyenler, hemşireler etkilenen organın çevre ölçüsünü de içeren detaylı fiziksel değerlendirme sonuçlarını ve sağlık geçmişi gibi bilgileri edinerek yüksek risk altındaki hastaları izlemelidirler (21).…”