Purpose
We examined the manipulation of resistance exercise load in a 12-week randomised controlled trial with a 4-month follow-up wherein effectiveness of training at either high load (HL) or low load (LL) was assessed to refine exercise prescription for management of breast cancer-related lymphedema (BCRL).
Participants and methods
Survivors with BCRL (n=94, aged 22-84 years, mean 54 years) were randomly allocated to usual care (UC, n = 31), HL (n = 31) or LL (n = 32) exercise groups. Twice weekly exercise consisted of 2-4 sets of upper and lower body resistance exercises progressing from 8- to 5-repetition maximum (RM) for HL or progressing from 18- to 15-RM for LL plus aerobic training (15-25 minutes at 65-80% heart rate max). Lymphatic relative volume (LRV), muscle function and functional performance (repeated chair rise, 400-m walk) were assessed at baseline, 12 weeks, and 4-month follow-up. Statistical analyses included ANOVA and ANCOVA.
Results
Seventy-three participants completed the study. Both HL and LL reduced LRV (HL -8.6%, LL -7.8%; p=0.001) over the 12-week intervention compared to UC with no further significant change at 4-month follow-up. Muscle strength improved (p=0.001) in both exercise groups with no change in UC (chest press: HL 4.7kg, LL 3.8kg; seated row: HL 9.7kg, LL 4.9kg; leg extension: HL 5.6kg; LL 3.9kg), and no difference between HL and LL. Performance in the 400-m walk also improved with exercise for both HL (-36.2 sec, p=.025) and LL (-18.9 sec, p=.004) with HL producing significantly superior improvement compared to LL (p=.020), with no change for UC.
Conclusion
We demonstrated both high and low load resistance exercise is feasible in survivors with BCRL for effective management of lymphedema and is accompanied by improvements in physical and functional performance up to 4 months post exercise.