Systematic review and meta-analysis of the effects of exercise for those with cancer-related lymphedema

Singh, Ben, DiSipio, Tracey, Peake, Jonathan, & Hayes, Sandra C. (2016) Systematic review and meta-analysis of the effects of exercise for those with cancer-related lymphedema. Archives of Physical Medicine and Rehabilitation, 97(2), 302-315.e13.

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  • To evaluate the effects of exercise on cancer-related lymphedema and related symptoms, and to determine the need for those with lymphedema to wear compression during exercise.

Data Sources

  • CINAHL, Cochrane, Ebscohost, MEDLINE, Pubmed, ProQuest Health and Medical Complete, ProQuest Nursing and Allied Health Source, Science Direct and SPORTDiscus databases were searched for trials published prior to 1 January, 2015.

Study Selection

  • Randomised and non-randomised, controlled trials, and single group pre-post studies published in English-language were included. Twenty-one (exercise) and four (compression and exercise) studies met inclusion criteria.

Data Extraction

  • Data was extracted into tabular format using predefined data fields by one reviewer and assessed for accuracy by a second reviewer. Study quality was evaluated using the Effective Public Health Practice Project assessment tool.

Data Synthesis

  • Data was pooled using a random effects model to assess the effects of acute and long-term exercise on lymphedema and lymphedema-associated symptoms, with subgroup analyses for exercise mode and intervention length. There was no effect of exercise (acute or intervention) on lymphedema or associated symptoms with standardised mean differences from all analyses ranging between −0.2 and 0.1 (p-values ≥0.22). Findings from subgroup analyses for exercise mode (aerobic, resistance, mixed, other) and intervention duration (>12 weeks or ≤12 weeks) were consistent with these findings; that is, no effect on lymphedema or associated symptoms. There were too few studies evaluating the effect of compression during regular exercise to conduct a meta-analysis.


  • Individuals with secondary lymphedema can safely participate in progressive, regular exercise without experiencing a worsening of lymphedema or related-symptoms. However, the results also do not suggest any improvements will occur in lymphedema. At present, there is insufficient evidence to support or refute the current clinical recommendation to wear compression garments during regular exercise.

Impact and interest:

5 citations in Scopus
4 citations in Web of Science®
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ID Code: 87628
Item Type: Journal Article
Refereed: Yes
Keywords: cancer, exercise, lymphedema, lymphoedema, weight-lifting
DOI: 10.1016/j.apmr.2015.09.012
ISSN: 1532-821X
Divisions: Current > Schools > School of Clinical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
Copyright Owner: Copyright 2016 Elsevier
Copyright Statement: Licensed under the Creative Commons Attribution; Non-Commercial; No-Derivatives 4.0 International. DOI: 10.1016/j.apmr.2015.09.012
Deposited On: 22 Sep 2015 05:02
Last Modified: 01 Mar 2017 23:29

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