Buchan, J., Janda, M., Box, R., Schmitz, K., & Hayes, S. (2016). A randomized trial on the effect of exercise mode on breast cancer-related lymphedema. Medicine and Science in Sports and Exercise, 48, 1866–1874. 

To compare the effects of resistance versus aerobic exercise on lymphedema and fitness in women with breast cancer

Women were randomly assigned to exercise mode. Resistance exercise included a full-body strength training program with a gradual introduction of additional exercises for a total of 12 exercises by week 7. The aerobic group was involved in a range of exercises depending upon preference, such as walking, jogging, cycling, or swimming. Both groups were assigned to 150 minutes of supervised and unsupervised exercise each week at a metabolic equivalent of task (MET) level of 5 in weeks 7–12. Supervised one-on-one exercise sessions were held at the patients’ homes or other selected locations. Assessments were conducted at 12 and 24 weeks.

• N = 41   
• MEAN AGE = 56 years
• KEY DISEASE CHARACTERISTICS: Patients with breast cancer with a history of stable arm lymphedema, with an average of 56 months since initial diagnosis. All had stage I or II lymphedema.
• OTHER KEY SAMPLE CHARACTERISTICS: Women who reported usual exercise levels exceeding 75 minutes per week were excluded.

• SITE: Single site   
• SETTING TYPE: Multiple settings    
• LOCATION: Australia

PHASE OF CARE: Late effects and survivorship

Randomized, two-group trial stratified by lymphedema stage

• Bioimpedance spectroscopy
• Circumference measurement 
• Norman lymphedema survey
• Numerous body strength and endurance measurements
• Functional Assessment of Cancer Therapy-Breast (FACT-B), version 4
• Exercise logs

Ninety-two percent completed at least 75% of exercise sessions. No differences existed between groups or over time in lymphedema or associated symptoms. The aerobic group showed a decline in the number of symptoms at 12 weeks (–1.5 change in score, p = 0.05). Both groups improved upper body strength, and improvements were greater in the resistance exercise group (p < 0.01). Both groups had improved lower body strength and FACT-B measures.

Neither resistance nor aerobic exercise significantly improved objective measures of lymphedema. Both exercise modes were associated with improvement in fitness, strength, and quality of life.

• Small sample (< 100)
• Risk of bias (no blinding)
• Frequency of supervised exercise sessions is unclear.

Results from this study did not show that either resistance or aerobic exercise resulted in volume reduction of lymphedema. Both forms of exercise were associated with improved fitness, strength, endurance, and aspects of quality of life. Exercise has been shown not to increase lymphedema in several studies, and although it may not reduce lymphedema volume, it can be beneficial in other aspects. Nurses can educate patients to engage in physical activity and exercise.