Effects of resistance training on breast cancer-related arm lymphedema: a systematic review and dose-response meta-analysis.

PURPOSES: This meta-analysis aims to (1) examine how resistance training affects lymphedema and muscle strength; and (2) evaluate the extent of improvement in lymphedema with different exercise dosages in breast cancer patients.

METHODS

Eight English and Chinese electronic databases were searched from their inception up to April 7, 2024. A dose-response meta-analysis was performed with R software. Egger's regression analysis and funnel plots were utilized to assess the potential for publication bias.

RESULTS

Thirty studies were synthesized in the systematic review. Resistance training was found to reduce lymphedema (SMD = - 0.28; 95% CI = - 0.44 to - 0.15) and significantly enhance upper and lower limb muscle strength. High-intensity training [5 ~ 8 repetition maximum (RM)] with a frequency of four times per week and a duration of 120~180 min per week showed a larger effect on lymphedema compared to moderate- to low-intensity training (8 ~ 20 RM) with three or fewer sessions per week and a duration of up to 120 min. Additionally, exercise programs lasting 12 weeks were more effective than those lasting less than 12 weeks.

CONCLUSIONS

High-intensity resistance training is more effective than low-intensity training in reducing lymphedema and enhancing muscle strength. Breast cancer patients with lower tolerance to exercise intensity can achieve maximal benefits in improving lymphedema by appropriately increasing the frequency and duration of exercise. Additionally, patients are encouraged to exercise for at least 12 weeks to ensure the effects.