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Systematic Review and Meta-Analysis of the Effects of Exercise for Those With Cancer-Related Lymphedema

  • Ben Singh
    Correspondence
    Corresponding author Ben Singh, MRes, School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Victoria Park Rd, Kelvin Grove 4059, Queensland, Australia.
    Affiliations
    School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Queensland, Australia

    Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
    Search for articles by this author
  • Tracey Disipio
    Affiliations
    School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Queensland, Australia

    Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
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  • Jonathan Peake
    Affiliations
    Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia

    School of Biomedical Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia
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  • Sandra C. Hayes
    Affiliations
    School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Queensland, Australia

    Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
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Published:October 03, 2015DOI:https://doi.org/10.1016/j.apmr.2015.09.012

      Abstract

      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.

      Keywords

      List of abbreviations:

      CI (confidence interval), RCT (randomized controlled trial), SMD (standardized mean difference)
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