PDF herunterladen
J Reconstr Microsurg 2019; 35(01): 037-045
DOI: 10.1055/s-0038-1660832
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effect of Exercise on Breast Cancer–Related Lymphedema: What the Lymphatic Surgeon Needs to Know

Daniel Panchik
1   Department of Occupational Therapy, Elizabethtown College, Elizabethtown, Pennsylvania
,
Sarah Masco
2   Department of Occupational Therapy, Robert Wood Johnson University Hospital, Hamilton, New Jersey
,
Patrice Zinnikas
3   Department of Occupational Therapy, Genesis Rehab Services, Piscataway, New Jersey
,
Brooke Hillriegel
1   Department of Occupational Therapy, Elizabethtown College, Elizabethtown, Pennsylvania
,
Tori Lauder
1   Department of Occupational Therapy, Elizabethtown College, Elizabethtown, Pennsylvania
,
Erica Suttmann
1   Department of Occupational Therapy, Elizabethtown College, Elizabethtown, Pennsylvania
,
Vernon Chinchilli
4   Department of Public Health Sciences, PennState College of Medicine, Hershey, Pennsylvania
,
Maureen McBeth
5   Department of Physical Therapy, Bodywise Physical Therapy, LLC, Columbia, Maryland
,
William Hermann
6   Department of Occupational Therapy, WellSpan, York, Pennsylvania
› Institutsangaben
Weitere Informationen

Publikationsverlauf

14. Dezember 2017

26. April 2018

Publikationsdatum:
23. Juni 2018 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Abstract

Background Breast cancer–related lymphedema (BCRL) affects many areas of daily living. Individuals with lymphedema may experience chronic and progressive swelling, recurrent skin infections, and decreased self-image and quality of life. For many years, it was considered best practice for this population to avoid exercise; however, in recent years, research has begun to challenge this belief. This systematic review and meta-analyses examined the recent literature on the effects of exercise for patients with, or at risk for, BCRL to inform best practice.

Methods A total of 807 articles were retrieved from CINAHL, Academic Search Complete, Medline, and PubMed. Results were systematically filtered to 26 articles through inclusion criteria, exclusion criteria, and the Effective Public Health Practice Project quality assessment tool for quantitative studies. Data were pooled from studies containing relative and absolute volume measurements of limb volume, as well as upper extremity function measured by the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire; meta-analyses were conducted using SAS software.

Results The literature was reviewed and statistically analyzed. Results have indicated aerobic exercise, resistance exercise, stretching, yoga, qigong, and pilates can be safe and effective in the management of symptoms for those with, or at risk for, BCRL.

Conclusion Several forms of exercise appear to be safe interventions for clinicians to use when treating this population and offer benefits such as improved quality of life, strength, body mass index, and mental health and decreased pain and lymphatic swelling. Additional research should be conducted to further examine the efficacy and safety of nontraditional forms of exercise in the treatment of BCRL.

Keywords

breast cancer–related lymphedema - exercise - arm lymphedema - breast cancer
 

  • References

  • 1 American Cancer Society. Breast cancer facts & figures. American Cancer Society Website. Available at: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/breast-cancer-facts-and-figures/breast-cancer-facts-and-figures-2017-2018.pdf . 2018, Accessed November 15, 2017
    PubMedGoogle Scholar
  • 2 National Cancer Institute. Division of Cancer Control & Population Sciences. Statistics. NIH Website. Available at: https://cancercontrol.cancer.gov/ocs/statistics/statistics.html . 2016
    PubMedGoogle Scholar
  • 3 Lee BB, Laredo J, Neville R. Current status of lymphatic reconstructive surgery for chronic lymphedema: it is still an uphill battle!. Int J Angiol 2011; 20 (02) 73-80
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 4 Yamamoto T, Yamamoto N, Numahata T. , et al. Navigation lymphatic supermicrosurgery for the treatment of cancer-related peripheral lymphedema. Vasc Endovascular Surg 2014; 48 (02) 139-143
    CrossrefPubMedGoogle Scholar
  • 5 Silva AK, Chang DW. Vascularized lymph node transfer and lymphovenous bypass: Novel treatment strategies for symptomatic lymphedema. J Surg Oncol 2016; 113 (08) 932-939
    CrossrefPubMedGoogle Scholar
  • 6 Ahmed RL, Thomas W, Yee D, Schmitz KH. Randomized controlled trial of weight training and lymphedema in breast cancer survivors. J Clin Oncol 2006; 24 (18) 2765-2772
    CrossrefPubMedGoogle Scholar
  • 7 Schmitz KH. Balancing lymphedema risk: exercise versus deconditioning for breast cancer survivors. Exerc Sport Sci Rev 2010; 38 (01) 17-24
    CrossrefPubMedGoogle Scholar
  • 8 Kwan M, Cohn J. , Cormier et al. Exercise in patients with lymphedema: a systematic review of the contemporary literature. J Cancer Surviv 2011; 5 (04) 320-336
    CrossrefPubMedGoogle Scholar
  • 9 McKenzie DC, Kalda AL. Effect of upper extremity exercise on secondary lymphedema in breast cancer patients: a pilot study. J Clin Oncol 2003; 21 (03) 463-466
    CrossrefPubMedGoogle Scholar
  • 10 Togawa K, Ma H, Sullivan-Halley J. , et al. Risk factors for self-reported arm lymphedema among female breast cancer survivors: a prospective cohort study. Breast Cancer Res 2014; 16 (04) 414
    CrossrefPubMedGoogle Scholar
  • 11 Ridner SH, Fu MR, Wanchai A, Stewart BR, Armer JM, Cormier JN. Self-management of lymphedema: a systematic review of the literature from 2004 to 2011. Nurs Res 2012; 61 (04) 291-299
    CrossrefPubMedGoogle Scholar
  • 12 Türk G, Khorshid L. The complete decongestive therapy in lymphedema management developing in relation with mastectomy. J Breast Health 2011; 7 (02) 96-100
    PubMedGoogle Scholar
  • 13 NLN Medical Advisory Committee. Position statement of the national lymphedema network: the diagnosis and treatment of lymphedema. Lymphnet.org website. Available at: https://www.lymphnet.org/pdfDocs/position.papers/Diagnosis.Treatment.pdf . Accessed March 1, 2016
    PubMedGoogle Scholar
  • 14 Schmitz KH, Ahmed RL, Troxel A. , et al. Weight lifting in women with breast-cancer-related lymphedema. N Engl J Med 2009; 361 (07) 664-673
    CrossrefPubMedGoogle Scholar
  • 15 Cheema B, Gaul CA, Lane K, Fiatarone Singh MA. Progressive resistance training in breast cancer: a systematic review of clinical trials. Breast Cancer Res Treat 2008; 109 (01) 9-26
    CrossrefPubMedGoogle Scholar
  • 16 Singh B, Disipio T, Peake J, Hayes SC. Systematic review and meta-analysis of the effects of exercise for those with cancer-related lymphedema. Arch Phys Med Rehabil 2016; 97 (02) 302-315.e13
    CrossrefPubMedGoogle Scholar
  • 17 Morris C, Wonders KY. Concise review on the safety of exercise on symptoms of lymphedema. World J Clin Oncol 2015; 6 (04) 43-44
    CrossrefPubMedGoogle Scholar
  • 18 Kwan ML, Cohn JC, Armer JM, Stewart BR, Cormier JN. Exercise in patients with lymphedema: a systematic review of the contemporary literature. J Cancer Surviv 2011; 5 (04) 320-336
    CrossrefPubMedGoogle Scholar
  • 19 EPHPP. Quality assessment tool for quantitative studies. Effective Public Health Practice Project Website. Available at: http://www.ephpp.ca/tools.html . 2009., Accessed January 22, 2016
    PubMedGoogle Scholar
  • 20 Ancukiewicz M, Miller CL, Skolny MN. , et al. Comparison of relative versus absolute arm size change as criteria for quantifying breast cancer-related lymphedema: the flaws in current studies and need for universal methodology. Breast Cancer Res Treat 2012; 135 (01) 145-152
    CrossrefPubMedGoogle Scholar
  • 21 Hayes SC, Rye S, Disipio T. , et al. Exercise for health: a randomized, controlled trial evaluating the impact of a pragmatic, translational exercise intervention on the quality of life, function and treatment-related side effects following breast cancer. Breast Cancer Res Treat 2013; 137 (01) 175-186
    CrossrefPubMedGoogle Scholar
  • 22 Institute for Work & Health. About the DASH. DASH website. Available at: http://www.dash.iwh.on.ca/about-dash . 2013., Accessed November 1, 2017
    PubMedGoogle Scholar
  • 23 Loudon A, Barnett T, Piller N, Immink MA, Williams AD. Yoga management of breast cancer-related lymphoedema: a randomised controlled pilot-trial. BMC Complement Altern Med 2014; 14: 214
    CrossrefPubMedGoogle Scholar
  • 24 Jönsson C, Johansson K. The effects of pole walking on arm lymphedema and cardiovascular fitness in women treated for breast cancer: a pilot and feasibility study. Physiother Theory Pract 2014; 30 (04) 236-242
    CrossrefPubMedGoogle Scholar
  • 25 Zhang X, Brown JC, Paskett ED, Zemel BS, Cheville AL, Schmitz KH. Changes in arm tissue composition with slowly progressive weight-lifting among women with breast cancer-related lymphedema. Breast Cancer Res Treat 2017; 164 (01) 79-88
    CrossrefPubMedGoogle Scholar
  • 26 Cormie P, Galvão DA, Spry N, Newton RU. Neither heavy nor light load resistance exercise acutely exacerbates lymphedema in breast cancer survivor. Integr Cancer Ther 2013; 12 (05) 423-432
    CrossrefPubMedGoogle Scholar
  • 27 Letellier ME, Towers A, Shimony A, Tidhar D. Breast cancer-related lymphedema: a randomized controlled pilot and feasibility study. Am J Phys Med Rehabil 2014; 93 (09) 751-759 , quiz 760–761
    CrossrefPubMedGoogle Scholar
  • 28 Johansson K, Hayes S, Speck RM, Schmitz KH. Water-based exercise for patients with chronic arm lymphedema: a randomized controlled pilot trial. Am J Phys Med Rehabil 2013; 92 (04) 312-319
    CrossrefPubMedGoogle Scholar
  • 29 Şener HÖ, Malkoç M, Ergin G, Karadibak D, Yavuzşen T. Effects of clinical Pilates exercises on patients developing lymphedema after breast cancer treatment: a randomized clinical trial. J Breast Health 2017; 13 (01) 16-22
    PubMedGoogle Scholar
  • 30 Fisher MI, Donahoe-Fillmore B, Leach L. , et al. Effects of yoga on arm volume among women with breast cancer related lymphedema: a pilot study. J Bodyw Mov Ther 2014; 18 (04) 559-565
    CrossrefPubMedGoogle Scholar
  • 31 DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986; 7 (03) 177-188
    CrossrefPubMedGoogle Scholar
  • 32 Kim DS, Sim YJ, Jeong HJ, Kim GC. Effect of active resistive exercise on breast cancer-related lymphedema: a randomized controlled trial. Arch Phys Med Rehabil 2010; 91 (12) 1844-1848
    CrossrefPubMedGoogle Scholar
  • 33 Simonavice E, Kim JS, Panton L. Effects of resistance exercise in women with or at risk for breast cancer-related lymphedema. Support Care Cancer 2017; 25 (01) 9-15
    CrossrefPubMedGoogle Scholar
  • 34 Park JH. The effects of complex exercise on shoulder range of motion and pain for women with breast cancer-related lymphedema: a single-blind, randomized controlled trial. Breast Cancer 2017; 24 (04) 608-614
    CrossrefPubMedGoogle Scholar
  • 35 Schmidt T, Berner J, Jonat W. , et al. Influence of arm crank ergometry on development of lymphedema in breast cancer patients after axillary dissection: A randomized controlled trail. J Rehabil Med 2017; 49 (01) 78-83
    CrossrefPubMedGoogle Scholar
  • 36 McClure MK, McClure RJ, Day R, Brufsky AM. Randomized controlled trial of the Breast Cancer Recovery Program for women with breast cancer-related lymphedema. Am J Occup Ther 2010; 64 (01) 59-72
    CrossrefPubMedGoogle Scholar
  • 37 Anderson RT, Kimmick GG, McCoy TP. , et al. A randomized trial of exercise on well-being and function following breast cancer surgery: the RESTORE trial. J Cancer Surviv 2012; 6 (02) 172-181
    CrossrefPubMedGoogle Scholar
  • 38 Cormie P, Pumpa K, Galvão DA. , et al. Is it safe and efficacious for women with lymphedema secondary to breast cancer to lift heavy weights during exercise: a randomised controlled trial. J Cancer Surviv 2013; 7 (03) 413-424
    CrossrefPubMedGoogle Scholar
  • 39 Kilbreath SL, Refshauge KM, Beith JM. , et al. Upper limb progressive resistance training and stretching exercises following surgery for early breast cancer: a randomized controlled trial. Breast Cancer Res Treat 2012; 133 (02) 667-676
    CrossrefPubMedGoogle Scholar
  • 40 Fernández-Lao C, Cantarero-Villanueva I, Ariza-Garcia A, Courtney C, Fernández-de-las-Peñas C, Arroyo-Morales M. Water versus land-based multimodal exercise program effects on body composition in breast cancer survivors: a controlled clinical trial. Support Care Cancer 2013; 21 (02) 521-530
    CrossrefPubMedGoogle Scholar
  • 41 Loudon A, Barnett T, Piller N, Immink MA, Visentin D, Williams AD. The effects of yoga on shoulder and spinal actions for women with breast cancer-related lymphoedema of the arm: a randomised controlled pilot study. BMC Complement Altern Med 2016; 16: 343 doi:10.1186/s12906-016-1330-7
    CrossrefPubMedGoogle Scholar
  • 42 Fong SSM, Ng SSM, Luk WS. , et al. Effects of qigong exercise on upper limb lymphedema and blood flow in survivors of breast cancer: a pilot study. Integr Cancer Ther 2014; 13 (01) 54-61
    CrossrefPubMedGoogle Scholar
  • 43 Puşcaş DM, Tache S. The importance of an exercise program in breast cancer related lymphedema. Civilization Sport 2015; 16 (02) 172-175
    PubMedGoogle Scholar
  • 44 Shaitelman SF, Cromwell KD, Rasmussen JC. , et al. Recent progress in the treatment and prevention of cancer-related lymphedema. CA Cancer J Clin 2015; 65 (01) 55-81
    CrossrefPubMedGoogle Scholar