Safety and efficacy of progressive resistance training in breast cancer: a systematic review and meta-analysis

Abstract

The purpose of this study was to assess the safety and efficacy of progressive resistance training (PRT) in breast cancer. Randomized controlled trials (RCTs) published to November 2013 that reported on the effects of PRT (>6 weeks) on breast cancer-related lymphedema (BCRL) (incidence/exacerbation, arm volume, and symptom severity), physical functioning (upper and lower body muscular strength), and health-related quality of life (HRQoL) in breast cancer patients were included. Of 446 citations retrieved, 15 RCTs in 1,652 patients were included and yielded five studies on BCRL incidence/exacerbation (N = 647), four studies on arm volume (N = 384) and BCRL symptom severity (N = 479), 11 studies on upper body muscular strength (N = 1,252), nine studies on lower body muscular strength (N = 1,079), and seven studies on HRQoL (N = 823). PRT reduced the risk of BCRL versus control conditions [OR = 0.53 (95% CI 0.31-0.90); I2 = 0%] and did not worsen arm volume or symptom severity (both SMD = -0.07). PRT significantly improved upper [SMD = 0.57 (95% CI 0.37-0.76); I2 = 58.4%] and lower body muscular strength [SMD = 0.48 (95% CI 0.30-0.67); I2 = 46.7%] but not HRQoL [SMD = 0.17 (95% CI -0.03 to 0.38); I2 = 47.0%]. The effect of PRT on HRQoL became significant in our sensitivity analysis when two studies conducted during adjuvant chemotherapy [SMD = 0.30 (95% CI 0.04-0.55), I2 = 37.0%] were excluded. These data indicate that PRT improves physical functioning and reduces the risk of BCRL. Clinical practice guidelines should be updated to inform clinicians on the benefits of PRT in this cohort.

Progressive resistance training to prevent arm lymphedema in the first year after breast cancer surgery: Results of a randomized controlled trial

“…LYCA is the first study to test whether PRT can prevent arm lymphedema in the first year after BC surgery. Contrary to our hypothesis, we found no evidence of a preventive effect of PRT on arm lymphedema development, although this was previously suggested . Our findings were consistent across measurements with ILVD, patient‐reported symptoms, clinically assessed criteria, and soft‐tissue ILMD.…”

The women in steady exercise research (WISER) survivor trial: The innovative transdisciplinary design of a randomized controlled trial of exercise and weight-loss interventions among breast cancer survivors with lymphedema

“…Randomized trials demonstrated that upper body strength training is safe and increases muscular strength among survivors suffering from lymphedema [13,14]. Our group previously demonstrated that a twice-weekly slowly-progressive weight training program halved the incidence of clinical events that required medical care for lymphedema [15], but had no effect on the cardinal feature of lymphedema: arm swelling.…”

Focal Muscle Vibration and Physical Exercise in Postmastectomy Recovery: An Explorative Study

“…These interventions have increased survival but can induce chronic side effects such as breast cancer-related lymphedema, upper body functional impairment, chronic fatigue, and psychological impairments (e.g., depression) [2]. …”