The effect of resistance exercise on the development of breast cancer-related lymphoedema

Abstract

Background: Breast cancer-related lymphoedema is a possible side-effect of breast cancer treatment (Fu, 2014). Inconsistent literature exists regarding the safety and potential protective effect of resistance exercise on lymphoedema development. Amid the growing population of breast cancer patients, a research question was formulated relating to this subject area: Among women at risk of developing breast cancer-related lymphoedema, does resistance exercise affect the development of this complication? The PICO framework was utilized as follows: (P) Women at risk of developing breast cancer-related lymphoedema, (I) Resistance exercise, (C) No exercise or alternative forms of exercise, (O) Development of breast cancer-related lymphoedema. Method: A systematic literature search was conducted using various electronic databases together with a reference hand-search. Limiters were added and inclusion/exclusion criteria were developed to refine the search according to the research question. Studies in the English language, investigating the effect of resistance exercise on the incidence of secondary lymphedema were included (Tables 2.5/2.6). A total of six randomised control trials were retrieved and the related CASP tool was utilized to critically appraise these studies. Results: All trials reported that progressive resistance exercise does not increase the risk of BCRL development. Some studies reported a lower lymphoedema incidence among resistance training groups, however this difference was not statically significant. Conclusions: These consistent findings suggest that resistance training can be safely pursued by those at risk of developing lymphoedema. However, further research is required to establish a preventative effect of this exercise upon lymphoedema development. Implications and recommendations: Patient advice regarding weight-lifting should be maintained and interventions promoting resistance exercise among breast cancer patients should be developed further. Education needs to be provided to health professionals to prevent the distribution of conflicting advice amongst breast cancer patients and survivors. The use of standardized evidence-based guidelines relating to resistance training should be considered.