TY - JOUR
T1 - The Effect of Exercise for the Prevention and Treatment of Cancer-Related Lymphedema
T2 - A Systematic Review with Meta-analysis
AU - Hayes, Sandra Christine
AU - Singh, Ben
AU - Reul-Hirche, Hildegard
AU - Bloomquist, Kira
AU - Johansson, Karin
AU - Jönsson, Charlotta
AU - Plinsinga, Melanie Louise
PY - 2022/8/1
Y1 - 2022/8/1
N2 - Introduction The purpose of this systematic review and meta-analysis was to evaluate the effects of exercise on (i) the prevention of cancer-related lymphedema (CRL) and (ii) the treatment of CRL, lymphedema-associated symptoms, and other health outcomes among individuals with CRL. Methods An electronic search was undertaken for exercise studies measuring lymphedema and involving individuals at risk of developing or with CRL. The Effective Public Health Practice Project Quality scale was used to assess study quality, and overall quality of evidence was assessed using the Grading of Recommendation, Assessment, Development and Evaluation approach. Meta-analyses were performed to evaluate effects of exercise on CRL incidence, existing CRL status, lymphedema-associated symptoms, and health outcomes. Results Twelve studies (n = 1955; 75% moderate-high quality) and 36 studies (n = 1741; 58% moderate-high quality) were included in the prevention and treatment aim, respectively. Relative risk of developing CRL for those in the exercise group compared with the nonexercise group was 0.90 (95% confidence interval (CI), 0.72 to 1.13) overall and 0.49 (95% CI, 0.28 to 0.85) for those with five or more lymph nodes removed. For those with CRL in the exercise group, the standardized mean difference (SMD) before to after exercise of CRL was-0.11 (95% CI,-0.22 to 0.01), and compared with usual care postintervention, the SMD was-0.10 (95% CI,-0.24 to 0.04). Improvements after intervention were observed for pain, upper-body function and strength, lower-body strength, fatigue, and quality of life for those in the exercise group (SMD, 0.3-0.8; P < 0.05). Conclusions Findings support the application of exercise guidelines for the wider cancer population to those with or at risk of CRL. This includes promotion of aerobic and resistance exercise, and not just resistance exercise alone, as well as unsupervised exercise guided by symptom response.
AB - Introduction The purpose of this systematic review and meta-analysis was to evaluate the effects of exercise on (i) the prevention of cancer-related lymphedema (CRL) and (ii) the treatment of CRL, lymphedema-associated symptoms, and other health outcomes among individuals with CRL. Methods An electronic search was undertaken for exercise studies measuring lymphedema and involving individuals at risk of developing or with CRL. The Effective Public Health Practice Project Quality scale was used to assess study quality, and overall quality of evidence was assessed using the Grading of Recommendation, Assessment, Development and Evaluation approach. Meta-analyses were performed to evaluate effects of exercise on CRL incidence, existing CRL status, lymphedema-associated symptoms, and health outcomes. Results Twelve studies (n = 1955; 75% moderate-high quality) and 36 studies (n = 1741; 58% moderate-high quality) were included in the prevention and treatment aim, respectively. Relative risk of developing CRL for those in the exercise group compared with the nonexercise group was 0.90 (95% confidence interval (CI), 0.72 to 1.13) overall and 0.49 (95% CI, 0.28 to 0.85) for those with five or more lymph nodes removed. For those with CRL in the exercise group, the standardized mean difference (SMD) before to after exercise of CRL was-0.11 (95% CI,-0.22 to 0.01), and compared with usual care postintervention, the SMD was-0.10 (95% CI,-0.24 to 0.04). Improvements after intervention were observed for pain, upper-body function and strength, lower-body strength, fatigue, and quality of life for those in the exercise group (SMD, 0.3-0.8; P < 0.05). Conclusions Findings support the application of exercise guidelines for the wider cancer population to those with or at risk of CRL. This includes promotion of aerobic and resistance exercise, and not just resistance exercise alone, as well as unsupervised exercise guided by symptom response.
KW - AEROBIC EXERCISE
KW - CANCER
KW - EXERCISE ONCOLOGY
KW - LYMPHEDEMA
KW - RESISTANCE EXERCISE
U2 - 10.1249/MSS.0000000000002918
DO - 10.1249/MSS.0000000000002918
M3 - Review article
C2 - 35320145
AN - SCOPUS:85134432662
SN - 0195-9131
VL - 54
SP - 1389
EP - 1399
JO - Medicine and Science in Sports and Exercise
JF - Medicine and Science in Sports and Exercise
IS - 8
ER -
