Decongestive Progressive Resistance Exercise with Advanced Compression for Breast Cancer Related Lymphedema Management (DREAM): A Pilot Randomized Control Trial

• Author / Creator

  Al Onazi, Mona Moraybed

• Introduction: More than one in five women who survive breast cancer will eventually develop lymphedema. Recent studies in breast cancer lymphedema management have demonstrated that resistance exercise can improve the survivors’ quality of life without exacerbating their lymphedema. However, research has not yet considered other elements of the lymphedema management regimen that may promote arm volume reduction. Using both compression and the decongestive exercise sequence in a progressive resistance exercise program has the potential to improve not only the survivors’ quality of life, but also their arm lymphedema volume.
  Objectives: A randomized controlled pilot trial was conducted to investigate the feasibility and preliminary efficacy of combining exercise and compression to improve arm lymphedema volume, arm function, and quality of life.
  Methods: Fifteen women with stable breast cancer related lymphedema were recruited through the Cross Cancer Institute and randomly assigned to one of the following three groups: (i) Standard care (n=6): home decongestive exercise regimen plus day time compression only, (ii) Decongestive Progressive Resistance Exercise (DPRE) plus use of a daytime compression sleeve during exercise (n=3), and (iii) DPRE plus use of an adjustable compression wrap garment during exercise (n=6).
  Data analysis: Feasibility outcomes were analyzed descriptively. For the purpose of analyses for the pilot study, the two DPRE groups were combined into a single DPRE group (n=9). An Independent samples T-test was used to compare the outcomes of the two groups to inform point estimates and measures of variability for a future multi-center trial.
  Results: Feasibility data demonstrated high study completion (93%), attendance (91%) and adherence to prescribed protocol of DPRE program (97%). A statistically significant between group difference was found in the mean change of excessive arm lymphedema volume (p=.027) in favour of the DPRE group. Moreover, statistically significant between group improvements in favour of DPRE group were found for upper body strength (p=0.048), and vitality (p=0.007).
  Conclusion: This pilot study showed that a twice weekly supervised DPRE program is feasible in women with BCRL, with preliminary evidence of benefit for reducing lymphedema arm volume and fatigue, and improving muscular strength. Results will guide the design and development of a large scale RCT.

• Subjects / Keywords

  • Breast Cancer
  • Oncology
  • Lymphedema
  • Rehabilitation
  • Physical Therapy
  • Exercise

• Graduation date

  Fall 2018

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/R34F1N11R

• License

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