The Effect of Yoga on Arm Volume, Strength, and Range of Motion in Women at Risk for Breast Cancer-Related Lymphedema

Mazor, Melissa; Lee, Jeannette Q.; Peled, Anne Warren; Zerzan, Sarah; Irwin, Chetan; Chesney, Margaret A.; Serrurier, Katherine M.; Sbitany, Hani; Dhruva, Anand; Sacks, Devorah; Smoot, Betty

doi:10.1089/acm.2017.0145

Cited by 31 publications

(60 citation statements)

References 33 publications

(42 reference statements)

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“…The finding that women in the LEAP group experienced faster improvement in ROM in the affected arm at 12 months from baseline compared with women in the EO group is consistent with the findings of previous studies 38,39 . This suggests that even minimal exercise may help women who undergo lymph node dissection to regain ROM quickly after surgery.…”

Section: Discussionsupporting

confidence: 89%

A randomized study to prevent lymphedema in women treated for breast cancer: CALGB 70305 (Alliance)

Paskett

Le‐Rademacher

Oliveri

et al. 2020

Cancer

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BackgroundLymphedema affects many women who are treated for breast cancer. We examined the effectiveness of an education‐only (EO) versus education plus sleeve compression/exercise intervention (lymphedema education and prevention [LEAP]) on lymphedema incidence and range of motion (ROM) in a group‐randomized trial across 38 cooperative group sites.MethodsThe treating institution was randomly assigned to either EO or LEAP by a study statistician. All patients at a treating institution participated in the same intervention (EO or LEAP) to minimize contamination bias. Participants completed surveys, arm volume measurements, and self‐reported ROM assessments before surgery and at 12 and 18 months after surgery. Lymphedema was defined as a ≥10% difference in limb volume at any time post‐surgery up to 18 months after surgery or diagnosis by a health provider. Cochran‐Mantel‐Haenszel tests were used to compare lymphedema‐free rates between groups, stratified by lymph node surgery type. Self‐reported ROM differences were compared between groups.ResultsA total of 554 participants (56% LEAP) were included in the analyses. At 18 months, lymphedema‐free rates were 58% (EO) versus 55% (LEAP) (P = .37). ROM for both arms was greater in LEAP versus EO at 12 months; by 18 months, most women reported full ROM, regardless of group. In LEAP, only one‐third wore a sleeve ≥75% of the time; 50% performed lymphedema exercises at least weekly.ConclusionLymphedema incidence did not differ by intervention group at 18 months. Poor adherence in the LEAP group may have contributed. However, physical therapy may speed recovery of ROM. Further research is needed to effectively reduce the incidence and severity of lymphedema in patients who have breast cancer.

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Section: Discussionsupporting

confidence: 89%

A randomized study to prevent lymphedema in women treated for breast cancer: CALGB 70305 (Alliance)

Paskett

Le‐Rademacher

Oliveri

et al. 2020

Cancer

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“…Several low-quality studies support yoga as a safe form of exercise for patients at risk for or with BCRL. 75–78 Mazor et al 75 (III) enrolled women at risk for BCRL in a weekly Ashtanga yoga program for 8 weeks. Individuals were instructed in poses to emphasize upper body strength and flexibility while minimizing dependent positions.…”

Section: Interventions Recommended For Individuals Diagnosed With Bcrmentioning

confidence: 99%

Interventions for Breast Cancer–Related Lymphedema: Clinical Practice Guideline From the Academy of Oncologic Physical Therapy of APTA

et al. 2020

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A work group from the American Physical Therapy Association (APTA) Academy of Oncologic Physical Therapy developed a clinical practice guideline to aid clinicians in identifying interventions for people with breast cancer–related lymphedema, targeting volume reduction, beginning at breast cancer diagnosis and continuing through cancer treatments and survivorship. Following a systematic review of published studies and a structured appraisal process, recommendations were developed to guide physical therapists and other health care clinicians in their intervention selection. Overall, clinical practice recommendations were formulated based on the evidence for each intervention and were assigned a grade based on the strength of the evidence. The evidence for each specific intervention was synthesized and appraised by lymphedema stage, when the information was available. In an effort to make recommendations clinically applicable, they were presented by modality throughout the care trajectory. Methodology and research populations varied significantly across studies, and it will be important for future research to use standardized definitions for participant characteristics, diagnostic criteria, and interventions.

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“…Studies with low numbers of subjects repeatedly show feasibility and various improvements but lack good evidence (e.g., ashtanga yoga [21] and dragon boat activity [22]). …”

Section: Continuedmentioning

confidence: 99%

Physical Activity, Exercise and Breast Cancer - What Is the Evidence for Rehabilitation, Aftercare, and Survival A Review

Wirtz

Baumann

2018

Breast Care

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The current scientific field of exercise interventions in breast cancer is very large. Rehabilitation focuses on restoring or improving quality of life and thus on independence and participation in life. Hence, it is important to investigate exercise interventions in the setting of rehabilitation and aftercare. It is also necessary to determine the influence of physical activity or exercise therapy on the prevention of recurrence and mortality as well as on certain side effects of the disease and its medical treatment in rehabilitation. Physical activity in rehabilitation and aftercare is feasible and safe and can be used for various purposes. Against the background of reduced fatigue, chemotherapy-induced peripheral neuropathy, cancer-related cognitive impairment, arthralgia, lymphedema, recurrence, and mortality, as well as improved quality of life, different methodological approaches and evidence can be seen. Although the overall data availability has increased, there are gaps in study documentation as well as inadequate verification of scientific approaches in rehabilitation clinics and in everyday life.

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The Effect of Yoga on Arm Volume, Strength, and Range of Motion in Women at Risk for Breast Cancer-Related Lymphedema

Abstract: These preliminary findings suggest that yoga is feasible and safe for women who are at risk for BCRL and may result in small improvements in shoulder ROM and UE strength.

Cited by 31 publications

References 33 publications

A randomized study to prevent lymphedema in women treated for breast cancer: CALGB 70305 (Alliance)

A randomized study to prevent lymphedema in women treated for breast cancer: CALGB 70305 (Alliance)

Interventions for Breast Cancer–Related Lymphedema: Clinical Practice Guideline From the Academy of Oncologic Physical Therapy of APTA

Physical Activity, Exercise and Breast Cancer - What Is the Evidence for Rehabilitation, Aftercare, and Survival A Review

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