Weight lifting in women with breast-cancer-related lymphedema.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.)
Schmitz
Kathryn H
KH
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. schmitz@mail.med.upenn.edu
Ahmed
Rehana L
RL
Troxel
Andrea
A
Cheville
Andrea
A
Smith
Rebecca
R
Lewis-Grant
Lorita
L
Bryan
Cathy J
CJ
Williams-Smith
Catherine T
CT
Greene
Quincy P
QP
D001943:Breast Neoplasms / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008209:Lymphedema / Q000209:etiology / Q000628:therapy*; D008408:Mastectomy; D008875:Middle Aged; D053580:Muscle Strength; D011183:Postoperative Complications / Q000628:therapy*; D016896:Treatment Outcome; D014891:Weight Lifting