Weight lifting in women with breast-cancer-related lymphedema

Kathryn H. Schmitz, Rehana L. Ahmed, Andrea Troxel, Andrea Cheville, Rebecca Smith, Lorita Lewis-Grant, Cathy J. Bryan, Catherine T. Williams-Smith, Quincy P. Greene

Research output: Contribution to journalArticle

341 Citations (Scopus)

Abstract

BACKGROUND: Weight lifting has generally been proscribed for women with breast-cancer-related lymphedema, preventing them from obtaining the well-established health benefits of weight lifting, including increases in bone density. METHODS: We performed a randomized, controlled trial of twice-weekly progressive weight lifting involving 141 breast-cancer survivors with stable lymphedema of the arm. The primary outcome was the change in arm and hand swelling at 1 year, as measured through displaced water volume of the affected and unaffected limbs. Secondary outcomes included the incidence of exacerbations of lymphedema, number and severity of lymphedema symptoms, and muscle strength. Participants were required to wear a well-fitted compression garment while weight lifting. RESULTS: The proportion of women who had an increase of 5% or more in limb swelling was similar in the weight-lifting group (11%) and the control group (12%) (cumulative incidence ratio, 1.00; 95% confidence interval, 0.88 to 1.13). As compared with the control group, the weight-lifting group had greater improvements in self-reported severity of lymphedema symptoms (P = 0.03) and upper- and lower-body strength (P<0.001 for both comparisons) and a lower incidence of lymphedema exacerbations as assessed by a certified lymphedema specialist (14% vs. 29%, P = 0.04). There were no serious adverse events related to the intervention. CONCLUSIONS: In breast-cancer survivors with lymphedema, slowly progressive weight lifting had no significant effect on limb swelling and resulted in a decreased incidence of exacerbations of lymphedema, reduced symptoms, and increased strength. (ClinicalTrials.gov number, NCT00194363.).

Original languageEnglish (US)
Pages (from-to)664-673
Number of pages10
JournalNew England Journal of Medicine
Volume361
Issue number7
DOIs
StatePublished - Aug 13 2009

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Weight Lifting
Lymphedema
Extremities
Incidence
Survivors
Arm
Breast Neoplasms
Control Groups
Clothing
Breast Cancer Lymphedema
Muscle Strength
Insurance Benefits
Bone Density
Randomized Controlled Trials
Hand
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Schmitz, K. H., Ahmed, R. L., Troxel, A., Cheville, A., Smith, R., Lewis-Grant, L., ... Greene, Q. P. (2009). Weight lifting in women with breast-cancer-related lymphedema. New England Journal of Medicine, 361(7), 664-673. https://doi.org/10.1056/NEJMoa0810118
Schmitz, Kathryn H. ; Ahmed, Rehana L. ; Troxel, Andrea ; Cheville, Andrea ; Smith, Rebecca ; Lewis-Grant, Lorita ; Bryan, Cathy J. ; Williams-Smith, Catherine T. ; Greene, Quincy P. / Weight lifting in women with breast-cancer-related lymphedema. In: New England Journal of Medicine. 2009 ; Vol. 361, No. 7. pp. 664-673.
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Schmitz, KH, Ahmed, RL, Troxel, A, Cheville, A, Smith, R, Lewis-Grant, L, Bryan, CJ, Williams-Smith, CT & Greene, QP 2009, 'Weight lifting in women with breast-cancer-related lymphedema', New England Journal of Medicine, vol. 361, no. 7, pp. 664-673. https://doi.org/10.1056/NEJMoa0810118

Weight lifting in women with breast-cancer-related lymphedema. / Schmitz, Kathryn H.; Ahmed, Rehana L.; Troxel, Andrea; Cheville, Andrea; Smith, Rebecca; Lewis-Grant, Lorita; Bryan, Cathy J.; Williams-Smith, Catherine T.; Greene, Quincy P.

In: New England Journal of Medicine, Vol. 361, No. 7, 13.08.2009, p. 664-673.

Research output: Contribution to journalArticle

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T1 - Weight lifting in women with breast-cancer-related lymphedema

AU - Schmitz, Kathryn H.

AU - Ahmed, Rehana L.

AU - Troxel, Andrea

AU - Cheville, Andrea

AU - Smith, Rebecca

AU - Lewis-Grant, Lorita

AU - Bryan, Cathy J.

AU - Williams-Smith, Catherine T.

AU - Greene, Quincy P.

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N2 - BACKGROUND: Weight lifting has generally been proscribed for women with breast-cancer-related lymphedema, preventing them from obtaining the well-established health benefits of weight lifting, including increases in bone density. METHODS: We performed a randomized, controlled trial of twice-weekly progressive weight lifting involving 141 breast-cancer survivors with stable lymphedema of the arm. The primary outcome was the change in arm and hand swelling at 1 year, as measured through displaced water volume of the affected and unaffected limbs. Secondary outcomes included the incidence of exacerbations of lymphedema, number and severity of lymphedema symptoms, and muscle strength. Participants were required to wear a well-fitted compression garment while weight lifting. RESULTS: The proportion of women who had an increase of 5% or more in limb swelling was similar in the weight-lifting group (11%) and the control group (12%) (cumulative incidence ratio, 1.00; 95% confidence interval, 0.88 to 1.13). As compared with the control group, the weight-lifting group had greater improvements in self-reported severity of lymphedema symptoms (P = 0.03) and upper- and lower-body strength (P<0.001 for both comparisons) and a lower incidence of lymphedema exacerbations as assessed by a certified lymphedema specialist (14% vs. 29%, P = 0.04). There were no serious adverse events related to the intervention. CONCLUSIONS: In breast-cancer survivors with lymphedema, slowly progressive weight lifting had no significant effect on limb swelling and resulted in a decreased incidence of exacerbations of lymphedema, reduced symptoms, and increased strength. (ClinicalTrials.gov number, NCT00194363.).

AB - BACKGROUND: Weight lifting has generally been proscribed for women with breast-cancer-related lymphedema, preventing them from obtaining the well-established health benefits of weight lifting, including increases in bone density. METHODS: We performed a randomized, controlled trial of twice-weekly progressive weight lifting involving 141 breast-cancer survivors with stable lymphedema of the arm. The primary outcome was the change in arm and hand swelling at 1 year, as measured through displaced water volume of the affected and unaffected limbs. Secondary outcomes included the incidence of exacerbations of lymphedema, number and severity of lymphedema symptoms, and muscle strength. Participants were required to wear a well-fitted compression garment while weight lifting. RESULTS: The proportion of women who had an increase of 5% or more in limb swelling was similar in the weight-lifting group (11%) and the control group (12%) (cumulative incidence ratio, 1.00; 95% confidence interval, 0.88 to 1.13). As compared with the control group, the weight-lifting group had greater improvements in self-reported severity of lymphedema symptoms (P = 0.03) and upper- and lower-body strength (P<0.001 for both comparisons) and a lower incidence of lymphedema exacerbations as assessed by a certified lymphedema specialist (14% vs. 29%, P = 0.04). There were no serious adverse events related to the intervention. CONCLUSIONS: In breast-cancer survivors with lymphedema, slowly progressive weight lifting had no significant effect on limb swelling and resulted in a decreased incidence of exacerbations of lymphedema, reduced symptoms, and increased strength. (ClinicalTrials.gov number, NCT00194363.).

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Schmitz KH, Ahmed RL, Troxel A, Cheville A, Smith R, Lewis-Grant L et al. Weight lifting in women with breast-cancer-related lymphedema. New England Journal of Medicine. 2009 Aug 13;361(7):664-673. https://doi.org/10.1056/NEJMoa0810118