Randomised controlled trial to determine the benefit of daily home-based exercise in addition to self-care in the management of breast cancer-related lymphoedema: a feasibility study.
Exercise is considered to be a key aspect of lymphoedema treatment, although there is little evidence for the therapeutic effect of exercise in managing breast cancer-related lymphoedema (BCRL). This small randomised controlled trial (RCT) was designed to determine the feasibility, prior to undertaking a larger RCT, of researching a daily home-based exercise programme to treat stable BCRL. An experimental design compared the exercise intervention combined with standard lymphoedema self-care to self-care alone over a 6-month period. Twenty-three women with stable unilateral BCRL of ≥10 % excess limb volume (ELV) were randomly allocated to a daily home-based exercise programme and self-care (n = 11) or self-care measures alone (n = 12). The primary objective was to determine difference in limb volume reduction for the two groups. Secondary objectives were to monitor change in other areas that impact BCRL: quality of life, arm function and range of shoulder movement. All 23 women completed the trial, providing full data for each time point. The intervention group showed a clinically and statistically significant improvement in relative ELV at week 26 (95 % confidence interval (CI) -26.57 to -5.12), whereas the control group improvement crossed the line of no effect (95 %CI -17.71 to 1.1). This study demonstrated the feasibility of conducting a RCT of exercise as a therapeutic intervention in the management of BCRL. Although the sample was small, the results support the findings of other exercise studies which have shown trends towards improvement.
Lymphoedema Clinic, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, 3rd floor Tower Wing, Great Maze Pond, London, SE1 9RT, UK. eunice.jeffs@gstt.nhs.uk
Eunice
E
Jeffs
Theresa
T
Wiseman
D000368:Aged; D001132:Arm; D001943:Breast Neoplasms / Q000150:complications*; D016001:Confidence Intervals; D004739:England; D005081:Exercise Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000209:etiology / Q000628:therapy*; D008875:Middle Aged; D012648:Self Care; D011795:Surveys and Questionnaires