Cheema, B.S., Kilbreath, S.L., Fahey, P.P., Delaney, G.P., & Atlantis, E. (2014). Safety and efficacy of progressive resistance training in breast cancer: A systematic review and meta-analysis. Breast Cancer Research and Treatment, 148, 249–268. 

DOI Link

Purpose

STUDY PURPOSE: To assess the safety and efficacy of progressive resistance training in patients with breast cancer with attention to effects on lymphedema

TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: MEDLINE, PubMed, Science direct, SPORT-discus, Scopus, Embase, Cinahl, and the Cochrane Library
 
KEYWORDS: Extensive sample search terms are provided; syntaxes were developed including terms for breast cancer, resistance training, weight training, and strength training
 
INCLUSION CRITERIA: Studies examining the isolated effects of resistance training (PRT) on breast cancer-related lymphedema, strength, or quality of life; intervention duration of at least six weeks
 
EXCLUSION CRITERIA: Use of aerobic training along with PRT unless the comparison group had the same dosage of aerobic training

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 446
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: A quality checklist was developed and used to score areas of randomization and blinding, the similarity of groups at baseline, eligibility specification, compliance reporting, supervision of the intervention, dropout reporting, data reported, adverse event reporting, and an intent to treat analysis

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 15
  • TOTAL PATIENTS INCLUDED IN REVIEW = 1,652
  • SAMPLE RANGE ACROSS STUDIES: 21–232 patients
  • KEY SAMPLE CHARACTERISTICS: Mean age ranged from 26–62 years

Phase of Care and Clinical Applications

PHASE OF CARE: Multiple phases of care

Results

For the five studies included in the meta-analysis (654 patients), the odds ratio for the incidence or exacerbation of lymphedema was 0.53 (95%, CI = 0.31–0.9). PRT did not change arm volume or patient-reported severity as shown by an analysis of standard mean differences. Five studies reported no adverse events, and other studies reported temporary muscle soreness or minor musculoskeletal injuries. There was no significant heterogeneity. PRT produced a small, nonsignificant improvement in quality of life (SMD = 0.17). Overall, PRT improved upper and lower body muscle strength. Ten studies used machines or free weights for training.

Conclusions

Progressive resistance training did not induce or exacerbate arm lymphedema in women with breast cancer, and it was not associated with any severe adverse events.

Limitations

Some included studies were done in women without lymphedema, and the risk of development was not clear from data in this review.

Nursing Implications

The findings of this meta-analysis suggested that progressive resistance training is safe in women with breast cancer and does not induce or exacerbate arm lymphedema. Women do not need to avoid lifting weight to prevent the exacerbation of lymphedema.

Legacy ID

5486