Systematic review and meta-analysis of the effects of exercise for those with cancer-related lymphedema
Open accessAbstract
Objectives To evaluate the effects of exercise on cancer-related lymphedema and related symptoms, and to determine the need for those with lymphedema to wear compression during exercise.Data sources CINAHL, Cochrane, EBSCOhost, MEDLINE, PubMed, ProQuest Health and Medical Complete, ProQuest Nursing and Allied Health Source, ScienceDirect, and SPORTDiscus databases were searched for trials published before January 1, 2015.Study selection Randomized and nonrandomized controlled trials and single-group pre-post studies published in English were included. Twenty-one (exercise) and 4 (compression and exercise) studies met inclusion criteria.Data extraction Data were extracted into tabular format using predefined data fields by 1 reviewer and assessed for accuracy by a second reviewer. Study quality was evaluated using the Effective Public Health Practice Project Quality Assessment Tool.Data synthesis Data were pooled using a random-effects model to assess the effects of acute and long-term exercise on lymphedema and lymphedema-associated symptoms, with subgroup analyses for exercise mode and intervention length. There was no effect of exercise (acute or intervention) on lymphedema or associated symptoms, with standardized mean differences from all analyses ranging between -0.2 and 0.1 (P values ≥.22). Findings from subgroup analyses for exercise mode (aerobic, resistance, mixed, other) and intervention duration (>12wk or ≤12wk) were consistent with these findings-that is, no effect on lymphedema or associated symptoms. There were too few studies evaluating the effect of compression during regular exercise to conduct a meta-analysis.Conclusions Individuals with secondary lymphedema can safely participate in progressive, regular exercise without experiencing a worsening of lymphedema or related symptoms. However, there is insufficient evidence to support or refute the current clinical recommendation to wear compression garments during regular exercise.
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There is a history of clinical recommendations to refrain from aerobic or resistance training to avoid onset or exacerbation of lymphedema.
“There is a history of clinical recommendations to refrain from aerobic or resistance training in order to avoid onset or exacerbation of lymphedema(33, 34).”
From Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable (2019) · cites this paper as [33]
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References 71 · Cited by 119
Research works printed but not linked: 5
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- Foldi M, Foldi E. Foldi's Textbook of Lymphology. 2 ed. Munchen: Elsevier; 2006.
- Harris SR, Niesen-Vertommen SL. Challenging the myth of exercise-induced lymphedema following breast cancer: a series of case reports. Journal of Surgical Oncology 2000;74:95-98.
- Deeks JJ, Higgins JPT, Altman DG. Analysing Data and Undertaking Meta-Analyses, in Cochrane Handbook for Systematic Reviews of Interventions. John Wiley & Sons, Ltd 2008:243-296.
- Irdesel J, Lenfödem TB, Giysileri ve EE. Effectiveness of exercise and compression garments in the treatment of breast cancer related lymphedema. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi 2007;53:16-21.
- Authors
- Singh, B., Disipio, T., Peake, J., & Hayes, S. C.
- Affiliations
- Queensland University of Technology (AU)
- Corresponding author
- Singh, Ben
- Venue
- Archives of Physical Medicine and Rehabilitation
- Publisher
- Elsevier BV
- Published
- 2016-02
- Volume
- 97
- Issue
- 2
- Pages
- 302-315.e13
- ISSN
- 0003-9993 (ISSN-L)
- OpenAlex
- W1876350010
- Cited by
- 119
- References
- 71
- Citations by year
- 2026: 5 · 2025: 13 · 2024: 14 · 2023: 6 · 2022: 15 · 2021: 14 · 2020: 14 · 2019: 8 · 2018: 11 · 2017: 11 · 2016: 8
- FWCI
- 1.07
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Physical Medicine and Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- QUT ePrints (Queensland University of Technology) (submittedVersion, cc-by-nc-nd)
- Griffith Research Online (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Oncology › Lymphatic System and Diseases
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Surgery › Lymphatic Disorders and Treatments
- Keywords
- cancer-related lymphedema, physical activity, compression garments, aerobic exercise, resistance training, exercise safety, intervention duration, exercise mode
- MeSH terms
- Humans, Lymphedema, Neoplasms, Exercise, Compression Bandages
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