title: Exercise and secondary lymphedema: safety, potential benefits, and research issues.
abstract: OBJECTIVE
  Participating in regular physical activity is encouraged after treatment for breast cancer, with exception of those who have subsequently developed lymphedema. The purpose of this project was to investigate, in a randomized controlled trial, the effect of participating in a supervised, mixed-type exercise program on lymphedema status among women with lymphedema after breast cancer.
  
  
  METHODS
  Women younger than 76 yr, who completed breast cancer treatment at least 6 months prior and had subsequently developed unilateral, upper-limb lymphedema, were randomly allocated to an intervention (n = 16) or control (n = 16) group. The intervention group (IG) participated in 20 supervised, group, aerobic and resistance exercise sessions over 12 wk, whereas the control group (CG) was instructed to continue habitual activities. Lymphedema status was assessed by bioimpedance spectroscopy (impedance ratio between limbs) and perometry (volume difference between limbs), and independent t-tests (two-tailed P < 0.05) were used to determine statistical significance of observed changes.
  
  
  RESULTS
  Mean ratio and volume measures at baseline were similar for the IG (1.13 +/- 0.15 and 337 +/- 307 mL, respectively) and the CG (1.13 +/- 0.19 and 377 +/- 416 mL, respectively), and no changes were observed over time for either group. Although no group change was observed between preintervention and 3-month follow-up for the IG (ratio and volume change = 0.02 +/- 0.07 and 2 +/- 71 mL, respectively), two women in this group no longer had evidence of lymphedema by study end. Average attendance was more than 70% of supervised sessions, there were no withdrawals, and several qualitative comments from participants support the program acceptability.
  
  
  CONCLUSIONS
  The results from this pilot study indicate that, at minimum, exercise does not exacerbate secondary lymphedema. Women with secondary lymphedema should be encouraged to be physically active, optimizing their physical and psychosocial recovery.
authors.affiliation: School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia. sc.hayes@qut.edu.au
authors.forename: Sandi C
authors.initials: SC
authors.lastname: Hayes
authors.forename: Hildegard
authors.initials: H
authors.lastname: Reul-Hirche
authors.forename: Jane
authors.initials: J
authors.lastname: Turner
mesh_terms: D000368:Aged; D001823:Body Composition; D001943:Breast Neoplasms / Q000150:complications*; D017097:Electric Impedance; D015444:Exercise; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D010865:Pilot Projects; D055070:Resistance Training; D016037:Single-Blind Method; D013057:Spectrum Analysis; D016896:Treatment Outcome