Article

Weight Lifting in Women with Breast-Cancer-Related Lymphedema

Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
New England Journal of Medicine (Impact Factor: 54.42). 09/2009; 361(7):664-73. DOI: 10.1056/NEJMoa0810118
Source: PubMed

ABSTRACT Weight lifting has generally been proscribed for women with breast-cancer-related lymphedema, preventing them from obtaining the well-established health benefits of weight lifting, including increases in bone density.
We performed a randomized, controlled trial of twice-weekly progressive weight lifting involving 141 breast-cancer survivors with stable lymphedema of the arm. The primary outcome was the change in arm and hand swelling at 1 year, as measured through displaced water volume of the affected and unaffected limbs. Secondary outcomes included the incidence of exacerbations of lymphedema, number and severity of lymphedema symptoms, and muscle strength. Participants were required to wear a well-fitted compression garment while weight lifting.
The proportion of women who had an increase of 5% or more in limb swelling was similar in the weight-lifting group (11%) and the control group (12%) (cumulative incidence ratio, 1.00; 95% confidence interval, 0.88 to 1.13). As compared with the control group, the weight-lifting group had greater improvements in self-reported severity of lymphedema symptoms (P=0.03) and upper- and lower-body strength (P<0.001 for both comparisons) and a lower incidence of lymphedema exacerbations as assessed by a certified lymphedema specialist (14% vs. 29%, P=0.04). There were no serious adverse events related to the intervention.
In breast-cancer survivors with lymphedema, slowly progressive weight lifting had no significant effect on limb swelling and resulted in a decreased incidence of exacerbations of lymphedema, reduced symptoms, and increased strength. (ClinicalTrials.gov number, NCT00194363.)

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    • "A systematic review found that physical activity is associated with reduced breastcancer-specific and all-cause mortality [58]. Resistive exercise may reduce symptoms of lymphedema [41]. RCTs have shown that shortterm structured aerobic exercise programs may improve quality of life in breast cancer survivors [60]. "
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    • "Short-stretch bandages are applied with low to moderate tension and are more prominent at the ends of extremities, reduce tissue hardening, also known as fibrosis (Farrow, 2010b; Brice et al., 2002; King, 2001; Williams, 2005; Lerner, 2000; Foldi et al., 2005) Exercise, including lymphatic " Remedial Exercise " , has been shown to have increased beneficial effects for patients with lymphedema. Patients are encouraged to create individualized exercise programs with a lymphedema specialist (Schmitz et al., 2009; Johansson et al., 2005; Mustian et al., 2009). Exercise must be done while wearing a compression garment or bandage to alleviate the build up of interstitial fluid (Gultig, 2005). "
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