Physical activity and lymphedema (the PAL trial): Assessing the safety of progressive strength training in breast cancer survivors

Kathryn Schmitz, Andrea B. Troxel, Andrea Cheville, Lorita L. Grant, Cathy J. Bryan, Cynthia R. Gross, Leslie A. Lytle, Rehana L. Ahmed

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Lymphedema is a chronic and progressive long-term adverse effect of breast cancer treatment commonly defined by swelling of the affected arm. Current clinical guidelines indicate that women with and at risk for lymphedema should protect the affected arm from overuse. In clinical practice, this often translates into risk aversive guidance to avoid using the arm. This could lead to a disuse pattern that may increase the likelihood of injury from common activities of daily living. Further, such guidance poses an additional barrier to staying physically active, potentially translating to weight gain, which has been shown to be associated with worse clinical course for women with lymphedema. We hypothesize that a program of slowly progressive strength training with no upper limit on the amount of weight that may be lifted would gradually increase the physiologic capacity of the arm so that common activities represent a decreasing percentage of maximal capacity. Theoretically, this increased capacity should decrease the risk that daily activities put stress on the lymphatic system of the affected side. The Physical Activity and Lymphedema (PAL) Trial is a recently completed randomized controlled exercise intervention trial that recruited 295 breast cancer survivors (141 with lymphedema at study entry, 154 at risk for lymphedema at study entry). The purpose of this report is to provide detail regarding the study design, statistical design, and protocol of the PAL trial.

Original languageEnglish (US)
Pages (from-to)233-245
Number of pages13
JournalContemporary Clinical Trials
Volume30
Issue number3
DOIs
StatePublished - May 1 2009

Fingerprint

Lymphedema
Resistance Training
Survivors
Exercise
Breast Neoplasms
Safety
Lymphatic System
Activities of Daily Living
Weight Gain
Guidelines
Weights and Measures
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

Schmitz, Kathryn ; Troxel, Andrea B. ; Cheville, Andrea ; Grant, Lorita L. ; Bryan, Cathy J. ; Gross, Cynthia R. ; Lytle, Leslie A. ; Ahmed, Rehana L. / Physical activity and lymphedema (the PAL trial) : Assessing the safety of progressive strength training in breast cancer survivors. In: Contemporary Clinical Trials. 2009 ; Vol. 30, No. 3. pp. 233-245.
@article{af967a16deca487daccaf30066ea4b8e,
title = "Physical activity and lymphedema (the PAL trial): Assessing the safety of progressive strength training in breast cancer survivors",
abstract = "Lymphedema is a chronic and progressive long-term adverse effect of breast cancer treatment commonly defined by swelling of the affected arm. Current clinical guidelines indicate that women with and at risk for lymphedema should protect the affected arm from overuse. In clinical practice, this often translates into risk aversive guidance to avoid using the arm. This could lead to a disuse pattern that may increase the likelihood of injury from common activities of daily living. Further, such guidance poses an additional barrier to staying physically active, potentially translating to weight gain, which has been shown to be associated with worse clinical course for women with lymphedema. We hypothesize that a program of slowly progressive strength training with no upper limit on the amount of weight that may be lifted would gradually increase the physiologic capacity of the arm so that common activities represent a decreasing percentage of maximal capacity. Theoretically, this increased capacity should decrease the risk that daily activities put stress on the lymphatic system of the affected side. The Physical Activity and Lymphedema (PAL) Trial is a recently completed randomized controlled exercise intervention trial that recruited 295 breast cancer survivors (141 with lymphedema at study entry, 154 at risk for lymphedema at study entry). The purpose of this report is to provide detail regarding the study design, statistical design, and protocol of the PAL trial.",
author = "Kathryn Schmitz and Troxel, {Andrea B.} and Andrea Cheville and Grant, {Lorita L.} and Bryan, {Cathy J.} and Gross, {Cynthia R.} and Lytle, {Leslie A.} and Ahmed, {Rehana L.}",
year = "2009",
month = "5",
day = "1",
doi = "10.1016/j.cct.2009.01.001",
language = "English (US)",
volume = "30",
pages = "233--245",
journal = "Contemporary Clinical Trials",
issn = "1551-7144",
publisher = "Elsevier Inc.",
number = "3",

}

Physical activity and lymphedema (the PAL trial) : Assessing the safety of progressive strength training in breast cancer survivors. / Schmitz, Kathryn; Troxel, Andrea B.; Cheville, Andrea; Grant, Lorita L.; Bryan, Cathy J.; Gross, Cynthia R.; Lytle, Leslie A.; Ahmed, Rehana L.

In: Contemporary Clinical Trials, Vol. 30, No. 3, 01.05.2009, p. 233-245.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Physical activity and lymphedema (the PAL trial)

T2 - Assessing the safety of progressive strength training in breast cancer survivors

AU - Schmitz, Kathryn

AU - Troxel, Andrea B.

AU - Cheville, Andrea

AU - Grant, Lorita L.

AU - Bryan, Cathy J.

AU - Gross, Cynthia R.

AU - Lytle, Leslie A.

AU - Ahmed, Rehana L.

PY - 2009/5/1

Y1 - 2009/5/1

N2 - Lymphedema is a chronic and progressive long-term adverse effect of breast cancer treatment commonly defined by swelling of the affected arm. Current clinical guidelines indicate that women with and at risk for lymphedema should protect the affected arm from overuse. In clinical practice, this often translates into risk aversive guidance to avoid using the arm. This could lead to a disuse pattern that may increase the likelihood of injury from common activities of daily living. Further, such guidance poses an additional barrier to staying physically active, potentially translating to weight gain, which has been shown to be associated with worse clinical course for women with lymphedema. We hypothesize that a program of slowly progressive strength training with no upper limit on the amount of weight that may be lifted would gradually increase the physiologic capacity of the arm so that common activities represent a decreasing percentage of maximal capacity. Theoretically, this increased capacity should decrease the risk that daily activities put stress on the lymphatic system of the affected side. The Physical Activity and Lymphedema (PAL) Trial is a recently completed randomized controlled exercise intervention trial that recruited 295 breast cancer survivors (141 with lymphedema at study entry, 154 at risk for lymphedema at study entry). The purpose of this report is to provide detail regarding the study design, statistical design, and protocol of the PAL trial.

AB - Lymphedema is a chronic and progressive long-term adverse effect of breast cancer treatment commonly defined by swelling of the affected arm. Current clinical guidelines indicate that women with and at risk for lymphedema should protect the affected arm from overuse. In clinical practice, this often translates into risk aversive guidance to avoid using the arm. This could lead to a disuse pattern that may increase the likelihood of injury from common activities of daily living. Further, such guidance poses an additional barrier to staying physically active, potentially translating to weight gain, which has been shown to be associated with worse clinical course for women with lymphedema. We hypothesize that a program of slowly progressive strength training with no upper limit on the amount of weight that may be lifted would gradually increase the physiologic capacity of the arm so that common activities represent a decreasing percentage of maximal capacity. Theoretically, this increased capacity should decrease the risk that daily activities put stress on the lymphatic system of the affected side. The Physical Activity and Lymphedema (PAL) Trial is a recently completed randomized controlled exercise intervention trial that recruited 295 breast cancer survivors (141 with lymphedema at study entry, 154 at risk for lymphedema at study entry). The purpose of this report is to provide detail regarding the study design, statistical design, and protocol of the PAL trial.

UR - http://www.scopus.com/inward/record.url?scp=67349090181&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67349090181&partnerID=8YFLogxK

U2 - 10.1016/j.cct.2009.01.001

DO - 10.1016/j.cct.2009.01.001

M3 - Article

C2 - 19171204

AN - SCOPUS:67349090181

VL - 30

SP - 233

EP - 245

JO - Contemporary Clinical Trials

JF - Contemporary Clinical Trials

SN - 1551-7144

IS - 3

ER -