High Intensity vs Low Intensity Resistive Exercise In Patient With Upper Extremity Lymphedema
Condition: Lymphedema
MeSH terms: Lymphedema
Study type: Interventional

Summary: 
      Lymphedema results from impaired lymphatic transport with increased limb volume. The results
      of systematic reviews indicate that breast cancer survivors can perform resistance exercise
      training at high-enough intensities to elicit strength gains without triggering changes to
      lymphedema status. There is strong evidence indicating that ret produces significant gains in
      muscular strength without provoking breast cancer-related lymphedema. On the one hand, the
      literature studies say future exercise programs will have to be evaluated in detail regarding
      intensity, volume, duration, frequency, and exercised muscle group. The purpose of this study
      is to examine the impact of upper body resistance exercise on the arm circumference, grip
      strength, pain, musculoskeletal disorders of the upper limbs, self-reported lymphedema
      symptoms, pinch strength, lymphedema functioning, disability, and health
      questionnaire/lymph-ıcf patient with upper extremity lymphedema and to compare these effects
      between resistance exercise involving high and low loads (heavier vs lighter weights).
    

Detailed description: 
      Lymphedema results from impaired lymphatic transport with increased limb volume.

      Lymphedema is divided into primary and secondary forms. Secondary lymphedema is likely to
      occur after the surgical removal of lymph nodes or in conjunction with radiotherapy.
      Secondary lymphedema is generally described as arm swelling and dysfunction. It is defined as
      an increase in arm circumference by more than 2 cm or as an accumulation of excessive
      protein-rich liquid in a part of the body where lymphatic vessels have been damaged.
      Erysipelas (cellulitis) is the main complication, but psychological or functional discomfort
      may occur throughout the course of lymphedema. The associated swelling may range from mild to
      disabling and is associated with feelings of distress, heaviness, and weakness in the arm,
      pain, and an increased risk for infection. These symptoms further impair the functional and
      self-care abilities of the individuals, causing significant psychological distress and
      reduced quality of life. Upper-limb lymphedema secondary to breast cancer treatment is the
      most frequent. Lymphedema management is based on complete decongestive physiotherapy
      (multilayer low-stretch bandage, manual lymph drainage, skincare, and exercises). The
      American college of sports medicine (ACSM) roundtable on exercise guidelines for cancer
      survivors describes that exercise during and after cancer treatment is safe and can help
      patients improve their physical capacity and quality of life. The ACSM guidelines indicate
      specific exercise programs oriented towards impairments associated with disease and medical
      treatment. Strength exercise does not have any adverse effects on an existing to; instead, it
      has beneficial effects such as improvement of strength and lower exacerbation rates. For
      breast cancer survivors who develop lymphedema, resistance exercise has been demonstrated to
      improve symptom severity, strength, endurance, and mobility of the affected limb, without
      exacerbating lymphedema. Recent evidence indicates that resistance exercise training can be
      an effective management strategy for breast cancer-related lymphedema by improving functional
      capacity and lymph flow through the pumping effect stimulated by muscular contraction. The
      results of systematic reviews indicate that breast cancer survivors can perform resistance
      exercise training at high-enough intensities to elicit strength gains without triggering
      changes to lymphedema status. There is strong evidence indicating that ret produces
      significant improvements in muscular strength without provoking breast cancer-related
      lymphedema. On the one hand, the literature studies say future exercise programs will have to
      be evaluated in detail regarding intensity, volume, duration, frequency, and exercised muscle
      group. The purpose of this study is examine the impact of upper body resistance exercise on
      the arm circumference, grip strength, pain, musculoskeletal disorders of the upper limbs,
      self-reported lymphedema symptoms, pinch strength, lymphedema functioning, disability, and
      health questionnaire/lymph-ıcf patient with upper extremity lymphedema and to compare these
      effects between resistance exercise involving high and low loads (heavier vs lighter
      weights).
    

Intervention name(s): High intensity resistive exercise; Low intensity resistive exercise
Intervention type(s): Other; Other
Intervention description(s): Participants of this group will be applied manual lymphatic drainage and compression bandaging every day of the week, and they will exercise for 25 minutes, three sets of each exercise at 80% intensity of 1 max repetition, 2 days of the week. Exercise training consist of warm-up and cool-down (10-15 repetitions of range of motion and 10 minutes of active stretching exercises) and resistive exercises.Each of the experimental sessions involved resistance exercises targeting all the major muscle groups in the upper body. Specifically, the exercises included the chest press, lat pull-down, bicep curl, triceps extension, lateral raise, and wrist curl.; participants in this group will be applied manual lymphatic drainage and compression bandaging every day of the week and they will exercise for 25 minutes, three sets of each exercise at 30% intensity of 1 max repetition 2 days of the week.
Exercise training consist of warm-up and cool-down (10-15 repetitions of range of motion and 10 minutes of active stretching exercises) and resistive exercises. Each of the experimental sessions involved resistance exercises targeting all the major muscle groups in the upper body. Specifically, the exercises included the chest press, lat pull- down, bicep curl, triceps extension, lateral raise, and wrist curl.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized controlled single-blind study
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Lymphedema; Resistive Exercises