Godoy Mde, F., Pereira, M.R., Oliani, A.H., & de Godoy, J.M. (2012). Synergic effect of compression therapy and controlled active exercises using a facilitating device in the treatment of arm lymphedema. International Journal of Medical Sciences, 9(4), 280–284.

To evaluate the effects of active exercise using a facilitating apparatus with compression on arm lymphedema secondary to breast cancer

Patients received two sessions of four, 12-minute stints of exercise using an active apparatus pulley system. The device was a vertical iron wheel fixed to a 30-cm-high support on a metal bench. The patient revolved the wheel, thus elevating the shoulder and stretching the arm. A homemade short-stretch compression sleeve made of a cotton polyester material was used during one of the exercise sessions. Arm volume measurements were taken before and immediately after each exercise session.

• The study sample (N = 20) was comprised of female patients who had breast cancer.
• Mean age was 63.3 years, with a range 49–82 years.
• All patients had a mean difference in arm volumes of at least 200 ml.

The study took place at an outpatient setting in Brazil.

The study has clinical applicability for late effects and survivorship.

The study used an observational single group design.

Arm volume was measured by water displacement.

A mean reduction in arm volume of 24.6 ml was seen in the exercise session while wearing the compression garment (p < 0.0004). Without the compression garment, arm volume increased by a mean of 9.7 ml.

The apparatus used here was effective for provision of active exercise. Without the compression garment, exercise increased arm volume slightly. The low stretch, inelastic compression had a synergistic effect with exercise to reduce arm volume.

• The sample size was small, with fewer than 30 participants.
• The study had a risk of bias because of no control group or blinding. 
• The standard deviations reported showed high variability of results in the study sample, suggesting actual effects were highly variable even within this small sample. 
• Whether the mean is truly representative of overall group results was not clear.

Findings demonstrated the importance of use of a compression mechanism during exercise in patients with lymphedema.