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The Effect of Exercise for the Prevention and Treatment of Cancer-Related Lymphedema : A Systematic Review with Meta-analysis

Hayes, Sandra Christine ; Singh, Ben ; Reul-Hirche, Hildegard ; Bloomquist, Kira ; Johansson, Karin LU ; Jönsson, Charlotta LU and Plinsinga, Melanie Louise (2022) In Medicine and Science in Sports and Exercise 54(8). p.1389-1399
Abstract

Introduction The purpose of this systematic review and meta-analysis was to evaluate the effects of exercise on (i) the prevention of cancer-related lymphedema (CRL) and (ii) the treatment of CRL, lymphedema-associated symptoms, and other health outcomes among individuals with CRL. Methods An electronic search was undertaken for exercise studies measuring lymphedema and involving individuals at risk of developing or with CRL. The Effective Public Health Practice Project Quality scale was used to assess study quality, and overall quality of evidence was assessed using the Grading of Recommendation, Assessment, Development and Evaluation approach. Meta-analyses were performed to evaluate effects of exercise on CRL incidence, existing CRL... (More)

Introduction The purpose of this systematic review and meta-analysis was to evaluate the effects of exercise on (i) the prevention of cancer-related lymphedema (CRL) and (ii) the treatment of CRL, lymphedema-associated symptoms, and other health outcomes among individuals with CRL. Methods An electronic search was undertaken for exercise studies measuring lymphedema and involving individuals at risk of developing or with CRL. The Effective Public Health Practice Project Quality scale was used to assess study quality, and overall quality of evidence was assessed using the Grading of Recommendation, Assessment, Development and Evaluation approach. Meta-analyses were performed to evaluate effects of exercise on CRL incidence, existing CRL status, lymphedema-associated symptoms, and health outcomes. Results Twelve studies (n = 1955; 75% moderate-high quality) and 36 studies (n = 1741; 58% moderate-high quality) were included in the prevention and treatment aim, respectively. Relative risk of developing CRL for those in the exercise group compared with the nonexercise group was 0.90 (95% confidence interval (CI), 0.72 to 1.13) overall and 0.49 (95% CI, 0.28 to 0.85) for those with five or more lymph nodes removed. For those with CRL in the exercise group, the standardized mean difference (SMD) before to after exercise of CRL was-0.11 (95% CI,-0.22 to 0.01), and compared with usual care postintervention, the SMD was-0.10 (95% CI,-0.24 to 0.04). Improvements after intervention were observed for pain, upper-body function and strength, lower-body strength, fatigue, and quality of life for those in the exercise group (SMD, 0.3-0.8; P < 0.05). Conclusions Findings support the application of exercise guidelines for the wider cancer population to those with or at risk of CRL. This includes promotion of aerobic and resistance exercise, and not just resistance exercise alone, as well as unsupervised exercise guided by symptom response.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
AEROBIC EXERCISE, CANCER, EXERCISE ONCOLOGY, LYMPHEDEMA, RESISTANCE EXERCISE
in
Medicine and Science in Sports and Exercise
volume
54
issue
8
pages
11 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:85134432662
  • pmid:35320145
ISSN
0195-9131
DOI
10.1249/MSS.0000000000002918
language
English
LU publication?
yes
id
3b910b9a-791c-4594-b798-1e8b5d3ce3db
date added to LUP
2022-09-22 14:49:14
date last changed
2024-06-13 21:08:53
@article{3b910b9a-791c-4594-b798-1e8b5d3ce3db,
  abstract     = {{<p>Introduction The purpose of this systematic review and meta-analysis was to evaluate the effects of exercise on (i) the prevention of cancer-related lymphedema (CRL) and (ii) the treatment of CRL, lymphedema-associated symptoms, and other health outcomes among individuals with CRL. Methods An electronic search was undertaken for exercise studies measuring lymphedema and involving individuals at risk of developing or with CRL. The Effective Public Health Practice Project Quality scale was used to assess study quality, and overall quality of evidence was assessed using the Grading of Recommendation, Assessment, Development and Evaluation approach. Meta-analyses were performed to evaluate effects of exercise on CRL incidence, existing CRL status, lymphedema-associated symptoms, and health outcomes. Results Twelve studies (n = 1955; 75% moderate-high quality) and 36 studies (n = 1741; 58% moderate-high quality) were included in the prevention and treatment aim, respectively. Relative risk of developing CRL for those in the exercise group compared with the nonexercise group was 0.90 (95% confidence interval (CI), 0.72 to 1.13) overall and 0.49 (95% CI, 0.28 to 0.85) for those with five or more lymph nodes removed. For those with CRL in the exercise group, the standardized mean difference (SMD) before to after exercise of CRL was-0.11 (95% CI,-0.22 to 0.01), and compared with usual care postintervention, the SMD was-0.10 (95% CI,-0.24 to 0.04). Improvements after intervention were observed for pain, upper-body function and strength, lower-body strength, fatigue, and quality of life for those in the exercise group (SMD, 0.3-0.8; P &lt; 0.05). Conclusions Findings support the application of exercise guidelines for the wider cancer population to those with or at risk of CRL. This includes promotion of aerobic and resistance exercise, and not just resistance exercise alone, as well as unsupervised exercise guided by symptom response. </p>}},
  author       = {{Hayes, Sandra Christine and Singh, Ben and Reul-Hirche, Hildegard and Bloomquist, Kira and Johansson, Karin and Jönsson, Charlotta and Plinsinga, Melanie Louise}},
  issn         = {{0195-9131}},
  keywords     = {{AEROBIC EXERCISE; CANCER; EXERCISE ONCOLOGY; LYMPHEDEMA; RESISTANCE EXERCISE}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{8}},
  pages        = {{1389--1399}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Medicine and Science in Sports and Exercise}},
  title        = {{The Effect of Exercise for the Prevention and Treatment of Cancer-Related Lymphedema : A Systematic Review with Meta-analysis}},
  url          = {{http://dx.doi.org/10.1249/MSS.0000000000002918}},
  doi          = {{10.1249/MSS.0000000000002918}},
  volume       = {{54}},
  year         = {{2022}},
}