strenuous arm activity after breast cancer surgery.

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strenuous arm activity after breast cancer surgery.

Postby patoco » Sun Jul 12, 2009 9:27 am

Factors that affect intention to avoid strenuous arm activity after breast cancer surgery.

Keywords: Lymphedema; Exercise; Breast cancer

Oncol Nurs Forum. 2009 Jul

Lee TS, Kilbreath SL, Sullivan G, Refshauge KM, Beith JM, Harris LM.
Physiotherapy Discipline, University of Sydney, Sydney, Australia.

PURPOSE/OBJECTIVES: To explore the factors that contribute to women's intention to avoid strenuous arm activity after breast cancer surgery.

DESIGN: Cross-sectional survey.

SETTING: Three hospitals located in eastern Australia. SAMPLE: 175 patients with breast cancer.

METHODS: A survey, based on Protection Motivation Theory, was used to assess whether treatment variables, demographic variables, arm advice, fear, or coping attributes predicted women's intentions to avoid strenuous arm activity.

MAIN RESEARCH VARIABLES: Intention to avoid strenuous arm activity, presence of arm or chest symptoms, receipt of arm care advice, and fear of lymphedema. FINDINGS: Seventy percent of participants reported an intention to avoid strenuous activity with their affected arm and reported more arm and chest symptoms than participants who did not avoid strenuous arm activity. Women who perceived that they were vulnerable to lymphedema and women who received advice about arm care were more likely to avoid strenuous arm activity.

CONCLUSIONS: Fear of lymphedema and receipt of arm care advice motivated women's intention to avoid strenuous arm activity.

IMPLICATIONS FOR NURSING: Information about lymphedema distributed to patients by healthcare professionals should be updated to reflect evidence and address the risk of developing lymphedema relevant to the patients' surgery.

PubMed ... d_RVDocSum

Physical activity for the affected limb and arm lymphedema after breast cancer surgery. A prospective, randomized controlled trial with two years follow-up.

Acta Oncol. 2009 Jun 23

Sagen A, Kåresen R, Risberg MA.
Department of Breast and Endocrine Surgery, Oslo University Hospital, Ullevaal, Norway.

Background. The influence of physical activity on the development of arm lymphedema (ALE) after breast cancer surgery with axillary node dissection has been debated. We evaluated the development of ALE in two different rehabilitation programs: a no activity restrictions (NAR) in daily living combined with a moderate resistance exercise program and an activity restrictions (AR) program combined with a usual care program. The risk factors associated with the development of ALE 2 years after surgery were also evaluated. Material and methods. Women (n=204) with a mean age of 55+/-10 years who had axillary node dissection were randomized into two different rehabilitation programs that lasted for 6 months: NAR (n=104) or AR (n=100). The primary outcomes were the difference in arm volume between the affected and control arms (Voldiff, in ml) and the development of ALE. Baseline (before surgery) and follow-up tests were performed 3 months, 6 months, and 2 years after surgery. Data were analyzed using ANCOVA and regression analysis. Results. Voldiff did not differ significantly between the two treatment groups. Arm volume increased significantly over time in both the affected and the control arms. The development of ALE from baseline to 2 years increased significantly in both groups (p<0.001). The only risk factor for ALE was BMI > 25 kg/m(2). Conclusion. Patients that undergo breast cancer surgery with axillary lymph node dissection should be encouraged to maintain physical activity in their daily lives without restrictions and without fear of developing ALE.

InformaWorld ... 0903061683

Pole walking for patients with breast cancer-related arm lymphedema.

Physiother Theory Pract. 2009 Apr

Jönsson C, Johansson K.
Lymphedema Unit, Lund University Hospital, Lund, Sweden.

Arm lymphedema is a well-known side effect of breast cancer treatment. Studies of the effect of physical exercise on arm lymphedema are very rare. The purpose of this study was to investigate the influence of pole walking on breast cancer-related arm lymphedema when using a compression sleeve. Twenty-six women with unilateral arm lymphedema took part in a clinical study of pole walking on one occasion, 4 kilometers for 1 hour. Measurements were made before, immediately after, and 24 hours later. Results revealed no changes in total arm volume of the swollen arm, measured with water displacement method, or in subjective assessments of heaviness and tightness in the affected arm using visual analogue scale. Immediately after pole walking, a temporary increase in total arm volume of the healthy arm (P=0.037) was found. Twenty-four hours later, no differences were found compared to the measurements before walking. The median for perceived exertion immediately after pole walking, measured with Borg scale, was 11 ("fairly light"). The results suggest that a controlled, short-duration pole-walking program can be performed by patients with arm lymphedema, using a compression sleeve, without deterioration of the arm lymphedema.

Informa World ... 0902776621

Physical activity and lymphedema (the PAL trial): Assessing the safety of progressive strength training in breast cancer survivors.

Contemp Clin Trials. 2009 May

Schmitz KH, Troxel AB, Cheville A, Grant LL, Bryan CJ, Gross CR, Lytle LA, Ahmed RL.
University of Pennsylvania School of Medicine, Philadelphia, PA, USA.

Lymphedema is a chronic and progressive long-term adverse effect of breast cancer treatment commonly defined by swelling of the affected arm. Current clinical guidelines indicate that women with and at risk for lymphedema should protect the affected arm from overuse. In clinical practice, this often translates into risk aversive guidance to avoid using the arm. This could lead to a disuse pattern that may increase the likelihood of injury from common activities of daily living. Further, such guidance poses an additional barrier to staying physically active, potentially translating to weight gain, which has been shown to be associated with worse clinical course for women with lymphedema. We hypothesize that a program of slowly progressive strength training with no upper limit on the amount of weight that may be lifted would gradually increase the physiologic capacity of the arm so that common activities represent a decreasing percentage of maximal capacity. Theoretically, this increased capacity should decrease the risk that daily activities put stress on the lymphatic system of the affected side. The Physical Activity and Lymphedema (PAL) Trial is a recently completed randomized controlled exercise intervention trial that recruited 295 breast cancer survivors (141 with lymphedema at study entry, 154 at risk for lymphedema at study entry). The purpose of this report is to provide detail regarding the study design, statistical design, and protocol of the PAL trial

Elsevier/ScienceDirect ... 4aeb681666
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