Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Journal of Cancer Survivorship
Erschienen in: Journal of Cancer Survivorship 4/2011

01.12.2011 | Reviews

Exercise in patients with lymphedema: a systematic review of the contemporary literature

verfasst von: Marilyn L. Kwan, Joy C. Cohn, Jane M. Armer, Bob R. Stewart, Janice N. Cormier

Erschienen in: Journal of Cancer Survivorship | Ausgabe 4/2011

Einloggen, um Zugang zu erhalten

Abstract

Background

Controversy exists regarding the role of exercise in cancer patients with or at risk for lymphedema, particularly breast. We conducted a systematic review of the contemporary literature to distill the weight of the evidence and provide recommendations for exercise and lymphedema care in breast cancer survivors.

Methods

Publications were retrieved from 11 major medical indices for articles published from 2004 to 2010 using search terms for exercise and lymphedema; 1,303 potential articles were selected, of which 659 articles were reviewed by clinical lymphedema experts for inclusion, yielding 35 articles. After applying exclusion criteria, 19 articles were selected for final review. Information on study design/objectives, participants, outcomes, intervention, results, and study strengths and weaknesses was extracted. Study evidence was also rated according to the Oncology Nursing Society Putting Evidence Into Practice® Weight-of-Evidence Classification.

Results

Seven studies were identified addressing resistance exercise, seven studies on aerobic and resistance exercise, and five studies on other exercise modalities. Studies concluded that slowly progressive exercise of varying modalities is not associated with the development or exacerbation of breast cancer-related lymphedema and can be safely pursued with proper supervision. Combined aerobic and resistance exercise appear safe, but confirmation requires larger and more rigorous studies.

Conclusions

Strong evidence is now available on the safety of resistance exercise without an increase in risk of lymphedema for breast cancer patients. Comparable studies are needed for other cancer patients at risk for lymphedema.

Implications for cancer survivors

With reasonable precautions, it is safe for breast cancer survivors to exercise throughout the trajectory of their cancer experience, including during treatment.
Literatur
1.
Armer JM. The problem of post-breast cancer lymphedema: impact and measurement issues. Cancer Invest. 2005;23(1):76–83.PubMed
2.
Petrek JA, Pressman PI, Smith RA. Lymphedema: current issues in research and management. CA Cancer J Clin. 2000;50(5):292–307. quiz 308–11.PubMedCrossRef
3.
McWayne J, Heiney SP. Psychologic and social sequelae of secondary lymphedema. Cancer. 2005;104(3):457–66.PubMedCrossRef
4.
Engel J, Kerr J, Schlesinger-Raab A, Sauer H, Holzel D. Axilla surgery severely affects quality of life: results of a 5-year prospective study in breast cancer patients. Breast Cancer Res Treat. 2003;79(1):47–57.PubMedCrossRef
5.
Kwan W, Jackson J, Weir LM, Dingee C, McGregor G, Olivotto IA. Chronic arm morbidity after curative breast cancer treatment: prevalence and impact on quality of life. J Clin Oncol. 2002;20(20):4242–8.PubMedCrossRef
6.
Kornblith AB, Herndon 2nd JE, Weiss RB, Zhang C, Zuckerman EL, Rosenberg S, et al. Long-term adjustment of survivors of early-stage breast carcinoma, 20 years after adjuvant chemotherapy. Cancer. 2003;98(4):679–89.PubMedCrossRef
7.
Ahmed RL, Prizment A, Lazovich D, Schmitz KH, Folsom AR. Lymphedema and quality of life in breast cancer survivors: the iowa women's health study. J Clin Oncol. 2008;26(35):5689–96.PubMedCrossRef
8.
Maunsell E, Brisson J, Deschenes L. Arm problems and psychological distress after surgery for breast cancer. Can J Surg. 1993;36(4):315–20.PubMed
9.
Passik S, Newman M, Brennan M, Holland J. Psychiatric consultation for women undergoing rehabilitation for upper-extremity lymphedema following breast cancer treatment. J Pain Symptom Manage. 1993;8(4):226–33.PubMedCrossRef
10.
Segerstrom K, Bjerle P, Nystrom A. Importance of time in assessing arm and hand function after treatment of breast cancer. Scand J Plast Reconstr Surg Hand Surg. 1991;25(3):241–4.PubMedCrossRef
11.
Tobin MB, Lacey HJ, Meyer L, Mortimer PS. The psychological morbidity of breast cancer-related arm swelling. Psychological morbidity of lymphoedema. Cancer. 1993;72(11):3248–52.PubMedCrossRef
12.
Velanovich V, Szymanski W. Quality of life of breast cancer patients with lymphedema. Am J Surg. 1999;177(3):184–7. discussion 188.PubMedCrossRef
13.
Jensen MR, Simonsen L, Karlsmark T, Bulow J. Lymphoedema of the lower extremities—background, pathophysiology and diagnostic considerations. Clin Physiol Funct Imaging. 2010;30(6):389–98.PubMedCrossRef
14.
Lawenda BD, Mondry TE, Johnstone PA. Lymphedema: a primer on the identification and management of a chronic condition in oncologic treatment. CA Cancer J Clin. 2009;59(1):8–24.PubMedCrossRef
15.
Harwood CA, Mortimer PS. Causes and clinical manifestations of lymphatic failure. Clin Dermatol. 1995;13(5):459–71.PubMedCrossRef
16.
Mortimer PS. The pathophysiology of lymphedema. Cancer. 1998;83(12 Suppl American):2798–802.PubMedCrossRef
17.
Erickson VS, Pearson ML, Ganz PA, Adams J, Kahn KL. Arm edema in breast cancer patients. J Natl Cancer Inst. 2001;93(2):96–111.PubMedCrossRef
18.
Cormier JN, Askew RL, Mungovan KS, Xing Y, Ross MI, Armer JM. Lymphedema beyond breast cancer: a systematic review and meta-analysis of cancer-related secondary lymphedema. Cancer. 2010;116(22):5138–49.PubMedCrossRef
19.
SEER Cancer Statistics Review, 1975–2007, National Cancer Institute, S. Altekruse, et al., Editors. 2009: Bethesda, MD.
20.
American Cancer Society. Breast Cancer Facts & Figures 2009–2010, Atlanta: American Cancer Society, Inc..
21.
Doyle C, Kushi LH, Byers T, Courneya KS, Demark-Wahnefried W, Grant B, et al. Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin. 2006;56(6):323–53.PubMedCrossRef
22.
Kushi LH, Byers T, Doyle C, Bandera EV, McCullough M, McTiernan A, et al. American Cancer Society Guidelines on Nutrition and Physical Activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin. 2006;56(5):254–81. quiz 313–4.PubMedCrossRef
23.
World Cancer Research Fund/American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington, DC: AICR; 2007.
24.
Physical Activities Guidelines Advisory Committee. Physical Activity Guidelines Advisory Committee Report. U.S. Department of Health and Human Services: Washington, DC; 2008
25.
Cheema B, Gaul CA, Lane K, Fiatarone Singh MA. Progressive resistance training in breast cancer: a systematic review of clinical trials. Breast Cancer Res Treat. 2008;109(1):9–26.PubMedCrossRef
26.
Ganz PA. The quality of life after breast cancer—solving the problem of lymphedema. N Engl J Med. 1999;340(5):383–5.PubMedCrossRef
27.
Rockson SG. Precipitating factors in lymphedema: myths and realities. Cancer. 1998;83(12 Suppl American):2814–6.PubMedCrossRef
28.
McKenzie DC. Abreast in a boat—a race against breast cancer. CMAJ. 1998;159(4):376–8.PubMed
29.
Unruh AM, Elvin N. In the eye of the dragon: women's experience of breast cancer and the occupation of dragon boat racing. Can J Occup Ther. 2004;71(3):138–49.PubMed
30.
Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010;42(7):1409–26.PubMedCrossRef
31.
Young-McCaughan S, Arzola SM. Exercise intervention research for patients with cancer on treatment. Semin Oncol Nurs. 2007;23(4):264–74.PubMedCrossRef
32.
Markes M, Brockow T, Resch KL. Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database Syst Rev. 2006(4):CD005001.
33.
Fappiano M, Gangaway J. Aquatic physical therapy improves joint mobility, strength, and edema in lower extremity orthopedic injuries. Journal of Aquatic Physical Therapy. 2008;16(1):10–5.
34.
Katz E, Dugan NL, Cohn JC, Chu C, Smith RG, Schmitz KH. Weight lifting in patients with lower-extremity lymphedema secondary to cancer: a pilot and feasibility study. Arch Phys Med Rehabil. 2010;91(7):1070–6.PubMedCrossRef
35.
Lymphoedema Framework. Best Practice for the Management of Lymphoedema. International consensus. London: MEP Ltd; 2006.
36.
37.
Steelman VM, Pape T, King CA, Graling P, Gaberson KB. Selection of a method to rate the strength of scientific evidence for AORN recommendations. AORN J. 2011;93(4):433–44.PubMedCrossRef
38.
Schmitz KH, Troxel AB, Cheville A, Grant LL, Bryan CJ, Gross CR, et al. Physical Activity and Lymphedema (the PAL trial): assessing the safety of progressive strength training in breast cancer survivors. Contemp Clin Trials. 2009;30(3):233–45.PubMedCrossRef
39.
Speck RM, Gross CR, Hormes JM, Ahmed RL, Lytle LA, Hwang WT, et al. Changes in the Body Image and Relationship Scale following a one-year strength training trial for breast cancer survivors with or at risk for lymphedema. Breast Cancer Res Treat. 2010;121(2):421–30.PubMedCrossRef
40.
Schmitz KH, Ahmed RL, Troxel A, Cheville A, Smith R, Lewis-Grant L, et al. Weight lifting in women with breast-cancer-related lymphedema. N Engl J Med. 2009;361(7):664–73.PubMedCrossRef
41.
Schmitz KH, Ahmed RL, Troxel AB, Cheville A, Lewis-Grant L, Smith R, et al. Weight lifting for women at risk for breast cancer-related lymphedema: a randomized trial. JAMA. 2010;304(24):2699–705.PubMedCrossRef
42.
Ahmed RL, Thomas W, Yee D, Schmitz KH. Randomized controlled trial of weight training and lymphedema in breast cancer survivors. J Clin Oncol. 2006;24(18):2765–72.PubMedCrossRef
43.
Sagen A, Karesen R, Risberg MA. Physical activity for the affected limb and arm lymphedema after breast cancer surgery. A prospective, randomized controlled trial with two years follow-up. Acta Oncol. 2009;48(8):1102–10.PubMedCrossRef
44.
Kilbreath SL, Refshauge KM, Beith JM, Ward LC, Simpson JM, Hansen RD. Progressive resistance training and stretching following surgery for breast cancer: study protocol for a randomised controlled trial. BMC Cancer. 2006;6:273.PubMedCrossRef
45.
Irdesel J, Kahraman Celiktas S. Effectiveness of exercise and compression garments in the treatment of breast cancer related lymphedema. Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi. 2007;53(1):16–21.
46.
Sander AP. A safe and effective upper extremity resistive exercise program for woman post breast cancer treatment. Rehabilitation Oncology. 2008;26(3):3–10.
47.
Courneya KS, Segal RJ, Mackey JR, Gelmon K, Reid RD, Friedenreich CM, et al. Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. J Clin Oncol. 2007;25(28):4396–404.PubMedCrossRef
48.
Bicego D, Brown K, Ruddick M, Storey D, Wong C, Harris SR. Exercise for women with or at risk for breast cancer-related lymphedema. Phys Ther. 2006;86(10):1398–405.PubMedCrossRef
49.
De Backer IC, Schep G, Backx FJ, Vreugdenhil G, Kuipers H. Resistance training in cancer survivors: a systematic review. Int J Sports Med. 2009;30(10):703–12.PubMedCrossRef
50.
Poage E, Singer M, Armer J, Poundall M, Shellabarger MJ. Demystifying lymphedema: development of the lymphedema putting evidence into practice card. Clin J Oncol Nurs. 2008;12(6):951–64.PubMedCrossRef
51.
Hayes SC, Reul-Hirche H, Turner J. Exercise and secondary lymphedema: safety, potential benefits, and research issues. Med Sci Sports Exerc. 2009;41(3):483–9.PubMedCrossRef
52.
Portela AL, Santaella CL, Gomez CC, Burch A. Feasibility of an exercise program for puerto rican women who are breast cancer survivors. Rehabil Oncol. 2008;26(2):20–31.PubMed
53.
Kilgour RD, Jones DH, Keyserlingk JR. Effectiveness of a self-administered, home-based exercise rehabilitation program for women following a modified radical mastectomy and axillary node dissection: a preliminary study. Breast Cancer Res Treat. 2008;109(2):285–95.PubMedCrossRef
54.
Moseley AL, Piller NB, Carati CJ. The effect of gentle arm exercise and deep breathing on secondary arm lymphedema. Lymphology. 2005;38(3):136–45.PubMed
55.
Beurskens CH, van Uden CJ, Strobbe LJ, Oostendorp RA, Wobbes T. The efficacy of physiotherapy upon shoulder function following axillary dissection in breast cancer, a randomized controlled study. BMC Cancer. 2007;7:166.PubMedCrossRef
56.
de Rezende LF, Franco RL, de Rezende MF, Beletti PO, Morais SS, Gurgel MS. Two exercise schemes in postoperative breast cancer: comparison of effects on shoulder movement and lymphatic disturbance. Tumori. 2006;92(1):55–61.PubMed
57.
Torres Lacomba M, Yuste Sanchez MJ, Zapico Goni A, Prieto Merino D, del Moral OMayoral, Cerezo Tellez E, et al. Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial. BMJ. 2010;340:b5396.PubMedCrossRef
58.
59.
Johansson K, Piller N. Weight-bearing exercise and its impact on arm lymphoedema. J Lymphoedema. 2007;2(1):15–22.
60.
Johansson K, Tibe K, Weibull A, Newton RC. Low intensity resistance exercise for breast cancer patients with arm lymphedema with or without compression sleeve. Lymphology. 2005;38(4):167–80.PubMed
61.
Jonsson C, Johansson K. Pole walking for patients with breast cancer-related arm lymphedema. Physiother Theory Pract. 2009;25(3):165–73.PubMedCrossRef
Metadaten
Titel
Exercise in patients with lymphedema: a systematic review of the contemporary literature
verfasst von
Marilyn L. Kwan
Joy C. Cohn
Jane M. Armer
Bob R. Stewart
Janice N. Cormier
Publikationsdatum
01.12.2011
Verlag
Springer US
Erschienen in
Journal of Cancer Survivorship / Ausgabe 4/2011
Print ISSN: 1932-2259
Elektronische ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-011-0203-9

Weitere Artikel der Ausgabe 4/2011

Journal of Cancer Survivorship 4/2011 Zur Ausgabe

Original Paper

How confident are young adult cancer survivors in managing their survivorship care? A report from the LIVESTRONG™ Survivorship Center of Excellence Network

Editorial

The Journal of Cancer Survivorship: retrospective and future directions

OriginalPaper

Do breast cancer survivors' post-surgery difficulties with recreational activities persist over time?

OriginalPaper

Survivorship care planning after the Institute of Medicine recommendations: how are we faring?

OriginalPaper

Cancer survivorship practices, services, and delivery: a report from the Children’s Oncology Group (COG) nursing discipline, adolescent/young adult, and late effects committees

OriginalPaper

Social welfare and legal constraints associated with work among breast and prostate cancer survivors: experiences from Ireland

Neu im Fachgebiet Onkologie

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

25.04.2024 NSCLC Nachrichten

Das Risiko für Rezidiv oder Tod von Patienten und Patientinnen mit reseziertem ALK-positivem NSCLC ist unter einer adjuvanten Therapie mit dem Tyrosinkinase-Inhibitor Alectinib signifikant geringer als unter platinbasierter Chemotherapie.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

23.04.2024 Medikamente in Schwangerschaft und Stillzeit Nachrichten

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise