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Effect of Upper Extremity Exercise on Secondary Lymphedema in Breast Cancer Patients: A Pilot Study

Donald C. McKenzie, Andrea L. Kalda

From the Division of Sports Medicine and School of Human Kinetics, University of British Columbia, Vancouver, British Columbia, Canada.

Address reprint requests to D.C. McKenzie, MD, PhD, The University of British Columbia, Division of Sports Medicine, 3055 Wesbrook Mall, Vancouver, BC, Canada V6T 1Z3; email: kari{at}interchange.ubc.ca.

Purpose: To examine the effect of a progressive upper-body exercise program on lymphedema secondary to breast cancer treatment.

Methods: Fourteen breast cancer survivors with unilateral upper extremity lymphedema were randomly assigned to an exercise (n = 7) or control group (n = 7). The exercise group followed a progressive, 8-week upper-body exercise program consisting of resistance training plus aerobic exercise using a Monark Rehab Trainer arm ergometer. Lymphedema was assessed by arm circumference and measurement of arm volume by water displacement. Patients were evaluated on five occasions over the experimental period. The Medical Outcomes Trust Short-Form 36 Survey was used to measure quality of life before and after the intervention. Significance was set at alpha 0.01.

Results: No changes were found in arm circumference or arm volume as a result of the exercise program. Three of the quality-of-life domains showed trends toward increases in the exercise group: physical functioning (P = .050), general health (P = .048), and vitality (P = .023). Mental health increased, although not significantly, for all subjects (P = .019). Arm volume measured by water displacement was correlated with calculated arm volume (r = .973, P < .001), although the exercise and control group means were significantly different (P < .001).

Conclusions: Participation in an upper-body exercise program caused no changes in arm circumference or arm volume in women with lymphedema after breast cancer, and they may have experienced an increase in quality of life. Additional studies should be done in this area to determine the optimum training program.

Supported by the Canadian Breast Cancer Research Initiative.

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