Physical activity and lower limb lymphedema among uterine cancer survivors

Justin C. Brown, Gabriella M. John, Saya Segal, Christina S. Chu, Kathryn Schmitz

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

PURPOSE: Physical activity (PA) is known to provide physical and mental health benefits to uterine cancer survivors. However, it is unknown if PA is associated with lower limb lymphedema (LLL), an accumulation of protein-rich fluid in the lower limbs. Therefore, we sought to examine the association between PA and LLL in uterine cancer survivors, with a focus on walking. METHODS: We conducted a cross-sectional study using mailed surveys among uterine cancer survivors who received care at a university-based cancer center. We asked about PA, walking, and LLL symptoms using validated self-report questionnaires. PA was calculated using MET-hours per week, and walking was calculated using blocks per day. RESULTS: The response rate to our survey was 43%. Among the 213 uterine cancer survivors in our survey, 36% were classified as having LLL. Compared with participants who reported <3 MET·h·wk -1of PA, participants who reported ≥18.0 MET·h·wk -1 of PA had an odds ratio of LLL of 0.32 (95% confidence interval, 0.15-0.69; Ptrend = 0.003). Stratified analyses suggested the association between PA and LLL existed only among women with body mass index (BMI) <30 kg·m-2 (Ptrend = 0.007) compared with women with BMI ≥30 kg·m-2 (Ptrend = 0.47). Compared with participants who reported <4.0 blocks per day of walking, participants who reported ≥12 blocks per day of walking had an odds ratio of LLL of 0.19 (95% confidence interval, 0.09-0.43; Ptrend < 0.0001). Stratified analyses suggested the association between walking and LLL was similar among women with BMI <30 kg·m-2 (P trend = 0.007) and women with BMI ≥30 kg·m-2 (Ptrend = 0.03). CONCLUSION: Participation in higher levels of PA or walking is associated with reduced proportions of LLL in dose-response fashion. These findings should be interpreted as preliminary and should be investigated in future studies.

Original languageEnglish (US)
Pages (from-to)2091-2097
Number of pages7
JournalMedicine and Science in Sports and Exercise
Volume45
Issue number11
DOIs
StatePublished - Nov 1 2013

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Uterine Neoplasms
Lymphedema
Survivors
Lower Extremity
Exercise
Walking
Body Mass Index
Odds Ratio
Confidence Intervals
Insurance Benefits
Self Report
Mental Health
Cross-Sectional Studies

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Brown, Justin C. ; John, Gabriella M. ; Segal, Saya ; Chu, Christina S. ; Schmitz, Kathryn. / Physical activity and lower limb lymphedema among uterine cancer survivors. In: Medicine and Science in Sports and Exercise. 2013 ; Vol. 45, No. 11. pp. 2091-2097.
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abstract = "PURPOSE: Physical activity (PA) is known to provide physical and mental health benefits to uterine cancer survivors. However, it is unknown if PA is associated with lower limb lymphedema (LLL), an accumulation of protein-rich fluid in the lower limbs. Therefore, we sought to examine the association between PA and LLL in uterine cancer survivors, with a focus on walking. METHODS: We conducted a cross-sectional study using mailed surveys among uterine cancer survivors who received care at a university-based cancer center. We asked about PA, walking, and LLL symptoms using validated self-report questionnaires. PA was calculated using MET-hours per week, and walking was calculated using blocks per day. RESULTS: The response rate to our survey was 43{\%}. Among the 213 uterine cancer survivors in our survey, 36{\%} were classified as having LLL. Compared with participants who reported <3 MET·h·wk -1of PA, participants who reported ≥18.0 MET·h·wk -1 of PA had an odds ratio of LLL of 0.32 (95{\%} confidence interval, 0.15-0.69; Ptrend = 0.003). Stratified analyses suggested the association between PA and LLL existed only among women with body mass index (BMI) <30 kg·m-2 (Ptrend = 0.007) compared with women with BMI ≥30 kg·m-2 (Ptrend = 0.47). Compared with participants who reported <4.0 blocks per day of walking, participants who reported ≥12 blocks per day of walking had an odds ratio of LLL of 0.19 (95{\%} confidence interval, 0.09-0.43; Ptrend < 0.0001). Stratified analyses suggested the association between walking and LLL was similar among women with BMI <30 kg·m-2 (P trend = 0.007) and women with BMI ≥30 kg·m-2 (Ptrend = 0.03). CONCLUSION: Participation in higher levels of PA or walking is associated with reduced proportions of LLL in dose-response fashion. These findings should be interpreted as preliminary and should be investigated in future studies.",
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Physical activity and lower limb lymphedema among uterine cancer survivors. / Brown, Justin C.; John, Gabriella M.; Segal, Saya; Chu, Christina S.; Schmitz, Kathryn.

In: Medicine and Science in Sports and Exercise, Vol. 45, No. 11, 01.11.2013, p. 2091-2097.

Research output: Contribution to journalArticle

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T1 - Physical activity and lower limb lymphedema among uterine cancer survivors

AU - Brown, Justin C.

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N2 - PURPOSE: Physical activity (PA) is known to provide physical and mental health benefits to uterine cancer survivors. However, it is unknown if PA is associated with lower limb lymphedema (LLL), an accumulation of protein-rich fluid in the lower limbs. Therefore, we sought to examine the association between PA and LLL in uterine cancer survivors, with a focus on walking. METHODS: We conducted a cross-sectional study using mailed surveys among uterine cancer survivors who received care at a university-based cancer center. We asked about PA, walking, and LLL symptoms using validated self-report questionnaires. PA was calculated using MET-hours per week, and walking was calculated using blocks per day. RESULTS: The response rate to our survey was 43%. Among the 213 uterine cancer survivors in our survey, 36% were classified as having LLL. Compared with participants who reported <3 MET·h·wk -1of PA, participants who reported ≥18.0 MET·h·wk -1 of PA had an odds ratio of LLL of 0.32 (95% confidence interval, 0.15-0.69; Ptrend = 0.003). Stratified analyses suggested the association between PA and LLL existed only among women with body mass index (BMI) <30 kg·m-2 (Ptrend = 0.007) compared with women with BMI ≥30 kg·m-2 (Ptrend = 0.47). Compared with participants who reported <4.0 blocks per day of walking, participants who reported ≥12 blocks per day of walking had an odds ratio of LLL of 0.19 (95% confidence interval, 0.09-0.43; Ptrend < 0.0001). Stratified analyses suggested the association between walking and LLL was similar among women with BMI <30 kg·m-2 (P trend = 0.007) and women with BMI ≥30 kg·m-2 (Ptrend = 0.03). CONCLUSION: Participation in higher levels of PA or walking is associated with reduced proportions of LLL in dose-response fashion. These findings should be interpreted as preliminary and should be investigated in future studies.

AB - PURPOSE: Physical activity (PA) is known to provide physical and mental health benefits to uterine cancer survivors. However, it is unknown if PA is associated with lower limb lymphedema (LLL), an accumulation of protein-rich fluid in the lower limbs. Therefore, we sought to examine the association between PA and LLL in uterine cancer survivors, with a focus on walking. METHODS: We conducted a cross-sectional study using mailed surveys among uterine cancer survivors who received care at a university-based cancer center. We asked about PA, walking, and LLL symptoms using validated self-report questionnaires. PA was calculated using MET-hours per week, and walking was calculated using blocks per day. RESULTS: The response rate to our survey was 43%. Among the 213 uterine cancer survivors in our survey, 36% were classified as having LLL. Compared with participants who reported <3 MET·h·wk -1of PA, participants who reported ≥18.0 MET·h·wk -1 of PA had an odds ratio of LLL of 0.32 (95% confidence interval, 0.15-0.69; Ptrend = 0.003). Stratified analyses suggested the association between PA and LLL existed only among women with body mass index (BMI) <30 kg·m-2 (Ptrend = 0.007) compared with women with BMI ≥30 kg·m-2 (Ptrend = 0.47). Compared with participants who reported <4.0 blocks per day of walking, participants who reported ≥12 blocks per day of walking had an odds ratio of LLL of 0.19 (95% confidence interval, 0.09-0.43; Ptrend < 0.0001). Stratified analyses suggested the association between walking and LLL was similar among women with BMI <30 kg·m-2 (P trend = 0.007) and women with BMI ≥30 kg·m-2 (Ptrend = 0.03). CONCLUSION: Participation in higher levels of PA or walking is associated with reduced proportions of LLL in dose-response fashion. These findings should be interpreted as preliminary and should be investigated in future studies.

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