Hayes, S.C., Reul-Hirche, H., & Turner, J. (2009). Exercise and secondary lymphedema: Safety, potential benefits, and research issues. Medicine and Science in Sports and Exercise, 41(3), 483-489.

To investigate the effect of participating in a supervised, mixed-type exercise program on lymphedema status among women with lymphedema after breast cancer

All measures were assessed before the intervention, immediately after the intervention, and at 12-week follow-up and were conducted by the same assessor who was blinded to participant group allocation. Participants were randomly allocated to the intervention group or the control group after being assessed before the intervention. The intervention involved a 12-week, mixed-type exercise program, including aerobic and resistance exercise.

• The study sample (N = 32) was comprised of female patients with breast cancer.
• Mean age of the sample was 59 years.
• Patients were objectively measured by Perometer with greater than 200 ml differences.
• Another 106 women who provided patient and treatment information were unable to participate because of the intervention requirements.

The study took place in an outpatient setting in Queensland.

The study used a randomized controlled trial design.

• Lymphedema was assessed via bioimpedance spectroscopy and perometry.
• Qualitative comments regarding the program and the lymphedema status provided by the women during exercise sessions were recorded.

There were no significant differences in lymphedema status at baseline or changes between testing phases observed between the intervention and control groups.

Women with lymphedema can safely participate in this type of education.

• The study had a small sample size (N < 100).
• Intervention requirements caused many patients (N = 106) to be ineligible.
• Generalizability for all the women treated for breast cancer should be cautioned.
• The study reported on short-term follow-up only.

Nurses should be aware 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.