Exercise and Compression for Lymphedema
- Conditions
- Breast Cancer Related Lymphedema
- Interventions
- Device: Adjustable Compression (AC) garment, worn during exerciseDevice: Compression sleeve, worn during exerciseDevice: Compression sleeve, daytime wearBehavioral: Home exercise programBehavioral: Decongestive Progressive Resistance Exercise program
- Registration Number
- NCT05022823
- Lead Sponsor
- AHS Cancer Control Alberta
- Brief Summary
The purpose of this study is to investigate the benefit of combining resistance exercise with use of a compression sleeve on arm lymphedema. In the study, participants will be taught a resistance exercise that follows the decongestive exercise sequence. This program is called "decongestive progressive resistance exercise" (DPRE). To evaluate the benefit from use of a compression garment on the arm. Some participants will wear their usual compression sleeve during exercise and others will use an adjustable compression wrap. The investigators hope to see if this type of combined program is helpful for women with lymphedema. The investigators also want to see if there are benefits from the addition of use of an adjustable compression wrap during exercise over use of a regularly prescribed compression sleeve.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- Female
- Target Recruitment
- 40
- Is a female with a history of breast cancer;
- Has undergone surgery, including sentinel lymph node biopsy or axillary lymph node dissection;
- Has visible and palpable unilateral mild to moderate BCRL of at least 200 ml inter-limb volume difference (full limb) or regional lymphedema: defined as a minimal volume difference of 100 ml or 5% in a segment of the arm (e.g. hand and forearm region, elbow and upper arm) after correcting for arm dominance;
- Has chronic lymphedema, defined as lymphedema that has been present for at least 3 months;
- Is in the lymphedema maintenance phase of conservative treatment;
- Uses a well fitted compression sleeve (not older than 1 month) and is agreeable to wear the sleeve for a minimum of 12 hours per day (providing a minimum of 30 mm Hg of pressure);
- Is agreeable to discontinuing other lymphedema treatments that are beyond standard care, including manual lymph drainage and intermittent pneumatic compression during the 12-week RCT period of the study.
- Is able to read and understand English.
- Are undergoing or are scheduled to receive chemotherapy or radiotherapy
- Presents with limb infection/ cellulitis, deep vein thrombosis, or have active metastatic disease;
- Has any neurological or cognitive deficit, is pregnant, uses a pacemaker, or has other uncontrolled health condition that may interfere with assessment and/or the progressive resistance exercise training intervention;
- Has any contraindications related to wearing compression on the limb, including arterial insufficiency or congestive heart failure;
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description DPRE + compression sleeve during exercise Compression sleeve, daytime wear Group B. Decongestive Progressive Resistance Exercise + compression sleeve use during exercise + daytime use of a compression sleeve (12 hours per day) DPRE + AC garment during exercise Adjustable Compression (AC) garment, worn during exercise Group C. Decongestive Progressive Resistance Exercise + Adjustable Compression (AC) garment use during exercise + daytime use of a compression sleeve (12 hours per day). Standard of Care Compression sleeve, daytime wear Group A (Control). Home decongestive exercise regimen + daytime use of a compression sleeve (12 hours per day) DPRE + AC garment during exercise Compression sleeve, daytime wear Group C. Decongestive Progressive Resistance Exercise + Adjustable Compression (AC) garment use during exercise + daytime use of a compression sleeve (12 hours per day). Standard of Care Home exercise program Group A (Control). Home decongestive exercise regimen + daytime use of a compression sleeve (12 hours per day) DPRE + compression sleeve during exercise Compression sleeve, worn during exercise Group B. Decongestive Progressive Resistance Exercise + compression sleeve use during exercise + daytime use of a compression sleeve (12 hours per day) DPRE + compression sleeve during exercise Decongestive Progressive Resistance Exercise program Group B. Decongestive Progressive Resistance Exercise + compression sleeve use during exercise + daytime use of a compression sleeve (12 hours per day) DPRE + AC garment during exercise Decongestive Progressive Resistance Exercise program Group C. Decongestive Progressive Resistance Exercise + Adjustable Compression (AC) garment use during exercise + daytime use of a compression sleeve (12 hours per day).
- Primary Outcome Measures
Name Time Method Change in Lymphedema Arm Volume Up to 24 weeks Lymphedema will be objectively measured using the optoelectronic limb volumeter (perometer).
- Secondary Outcome Measures
Name Time Method Change in Grip Strength Up to 24 weeks The Jamar hydraulic hand dynamometer will be used to measure grip strength.
Change in Extracellular Fluid Volume Up to 24 weeks Bioimpedance analysis (BIA) is specially designed to estimate extracellular fluid volume in the limb. BIA measures the impedance ratio of the affected and unaffected limb and the resulting calculated index provides an estimate of extracellular fluid volume.
Change in Muscle Strength Up to 24 weeks Muscle strength will be assessed with the one-repetition maximum (1-RM) method for bench press, leg press, and seated row. The 1-RM is the highest weight that can be lifted once using proper form, a smooth motion and without pain or other symptoms.
Health-Related Quality of Life (Lymph-ICF) Up to 24 weeks The Lymphedema Functioning, Disability, and Health (Lymph-ICF) questionnaire consists of 29 questions related to functional impairments, activity limitations, and participation restrictions in patients with upper limb lymphedema.The total score of the Lymph-ICF on the five areas ranges from 0 to 100, with a score of 0 meaning no impact and higher scores indicative of worse function or negative impact.
Exercise and Compression Adherence Up to 24 weeks Participants will be asked to record their adherence to their assigned exercise and compression intervention program using a daily diary.The adherence diary will collect details on exercise sessions performed each day, including sets, repetitions, and resistance weight, as well as use of the assigned compression sleeve (i.e. use of the garment during exercises and number of hours per day and days per week the compression sleeve is worn).
Health-Related Quality of Life (SF-36) Up to 24 weeks The Rand Short Form-36 Version 2 (SF-36) questionnaire is comprised of 36 questions that aim to evaluate the following eight models of HRQOL: physical functioning, role limitations due to physical health, bodily pain, general health perceptions, vitality/energy, social functioning, role limitations due to emotional problems, and general mental health.
Physical Activity Level Up to 24 weeks The Godin leisure-time exercise questionnaire (GLTEQ) will be used to assess the physical activity level. The Godin questionnaire is a self reported measure of the average duration and frequency of strenuous (heart beats rapidly), moderate (not exhausting), and mild activities (minimal effort), resistance training, and flexibility training exercise.
Change in Shoulder Range of Motion Up to 24 weeks Shoulder range of motion (ROM) will be measured using plastic goniometer and each arm will be measured separately for flexion, abduction, internal, external rotation, and horizontal abduction.
Trial Locations
- Locations (1)
Cross Cancer Institute
🇨🇦Edmonton, Alberta, Canada