Do, J.H., Kim, W., Cho, Y.K., Lee, J., Song, E.J., Chun, Y.M., & Jeon, J.Y. (2015). Effects of resistance exercises and complex decongestive therapy on arm function and muscular strength in breast cancer related lymphedema. Lymphology, 48, 184–196. Retrieved from https://journals.uair.arizona.edu/index.php/lymph/article/view/18835

To examine the effects of adding resistance exercise to complete decongestive therapy (CDT) on arm volume, function, strength, and quality of life

Patients were randomized to intervention and control groups. The control group received CDT alone for one to two weeks, and those with severe lymphedema also had bandaging. The intervention received the same CDT, as well as exercise using resistance bands. Resistance exercises included isolated shoulder movements five times per week for eight weeks with three sets of 10 repetitions of exercises. Study assessments were conducted at baseline and after eight weeks. Arm volume measurement was taken at two weeks.

• N = 44   
• MEAN AGE = 49.7 years
• FEMALES: 100%
• CURRENT TREATMENT: Not applicable
• KEY DISEASE CHARACTERISTICS: Breast cancer. All had confirmed secondary lymphedema.
• OTHER KEY SAMPLE CHARACTERISTICS: Body mass index greater than 25 was seen in 9% of intervention and 19% of control patients.

• SITE: Single site   
• SETTING TYPE: Outpatient    
• LOCATION: South Korea

PHASE OF CARE: Late effects and survivorship

Randomized, two group trial

• Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire for physical function and arm disability
• European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30)
• Arm circumference measurements
• Dynamometer muscle strength measurements

Both groups showed improvement in quality of life scores and arm volumes with no significant differences between groups. Arm disability scores were significantly lower in the intervention group post-treatment (p = 0.001).

The addition of resistance exercise to CDT improved arm function, reduced disability, and did not have any adverse effects on arm lymphedema volume.

• Small sample (< 100)
• Risk of bias (no blinding)
• Risk of bias (sample characteristics)
• More women in the control group had high body mass index associated with increased risk for lymphedema.

The findings support the addition of moderate intensity resistance exercise to CDT for the management of lymphedema. Resistance exercise was associated with improved function, less arm disability, and no adverse effects on lymphedema volume. Nurses can recommend that patients use moderate exercise of this sort. Resistance exercise can be done with resistance bands—an inexpensive and practical way to achieve this intervention.