Weight Lifting in Women with Breast-Cancer-Related Lymphedema
Identifieur interne : 006787 ( Main/Exploration ); précédent : 006786; suivant : 006788Weight Lifting in Women with Breast-Cancer-Related Lymphedema
Auteurs : Kathryn H. Schmitz [États-Unis] ; Rehana L. Ahmed [États-Unis] ; Andrea Troxel [États-Unis] ; Andrea Cheville [États-Unis] ; Rebecca Smith [États-Unis] ; Lorita Lewis-Grant [États-Unis] ; Cathy J. Bryan [États-Unis] ; Catherine T. Williams-Smith [États-Unis] ; Quincy P. Greene [États-Unis]Source :
- The New England journal of medicine [ 0028-4793 ] ; 2009.
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Abstract
BACKGROUND Weight lifting has generally been proscribed for women with breast-cancer-related lymphedema, preventing them from obtaining the well-established health benefits of weight lifting, including increases in bone density. METHODS We performed a randomized, controlled trial of twice-weekly progressive weight lifting involving 141 breast-cancer survivors with stable lymphedema of the arm. The primary outcome was the change in arm and hand swelling at 1 year, as measured through displaced water volume of the affected and unaffected limbs. Secondary outcomes included the incidence of exacerbations of lymphedema, number and severity of lymphedema symptoms, and muscle strength. Participants were required to wear a well-fitted compression garment while weight lifting. RESULTS The proportion of women who had an increase of 5% or more in limb swelling was similar in the weight-lifting group (11%) and the control group (12%) (cumulative incidence ratio, 1.00; 95% confidence interval, 0.88 to 1.13). As compared with the control group, the weight-lifting group had greater improvements in self-reported severity of lymphedema symptoms (P=0.03) and upper- and lower-body strength (P<0.001 for both comparisons) and a lower incidence of lymphedema exacerbations as assessed by a certified lymphedema specialist (14% vs. 29%, P=0.04). There were no serious adverse events related to the intervention. CONCLUSIONS In breast-cancer survivors with lymphedema, slowly progressive weight lifting had no significant effect on limb swelling and resulted in a decreased incidence of exacerbations of lymphedema, reduced symptoms, and increased strength. (ClinicalTrials.gov number, NCT00194363.).
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Schmitz</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine and Abramson Cancer Center</s1><s2>Philadelphia</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Philadelphie</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Ahmed, Rehana L" sort="Ahmed, Rehana L" uniqKey="Ahmed R" first="Rehana L." last="Ahmed">Rehana L. 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Bryan</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine and Abramson Cancer Center</s1><s2>Philadelphia</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Philadelphie</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Williams Smith, Catherine T" sort="Williams Smith, Catherine T" uniqKey="Williams Smith C" first="Catherine T." last="Williams-Smith">Catherine T. Williams-Smith</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine and Abramson Cancer Center</s1><s2>Philadelphia</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Philadelphie</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Greene, Quincy P" sort="Greene, Quincy P" uniqKey="Greene Q" first="Quincy P." last="Greene">Quincy P. Greene</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine and Abramson Cancer Center</s1><s2>Philadelphia</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Philadelphie</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author></analytic><series><title level="j" type="main">The New England journal of medicine</title><title level="j" type="abbreviated">N. Engl. j. med.</title><idno type="ISSN">0028-4793</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">The New England journal of medicine</title><title level="j" type="abbreviated">N. Engl. j. med.</title><idno type="ISSN">0028-4793</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Breast cancer</term><term>Female</term><term>Lifting</term><term>Lymphedema</term><term>Malignant tumor</term><term>Mammary gland</term><term>Medicine</term><term>Treatment</term><term>Weight</term><term>Woman</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Tumeur maligne</term><term>Poids</term><term>Femme</term><term>Cancer du sein</term><term>Femelle</term><term>Lymphoedème</term><term>Adulte</term><term>Glande mammaire</term><term>Médecine</term><term>Traitement</term><term>Lifting</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Femme</term><term>Adulte</term><term>Médecine</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">BACKGROUND Weight lifting has generally been proscribed for women with breast-cancer-related lymphedema, preventing them from obtaining the well-established health benefits of weight lifting, including increases in bone density. METHODS We performed a randomized, controlled trial of twice-weekly progressive weight lifting involving 141 breast-cancer survivors with stable lymphedema of the arm. The primary outcome was the change in arm and hand swelling at 1 year, as measured through displaced water volume of the affected and unaffected limbs. Secondary outcomes included the incidence of exacerbations of lymphedema, number and severity of lymphedema symptoms, and muscle strength. Participants were required to wear a well-fitted compression garment while weight lifting. RESULTS The proportion of women who had an increase of 5% or more in limb swelling was similar in the weight-lifting group (11%) and the control group (12%) (cumulative incidence ratio, 1.00; 95% confidence interval, 0.88 to 1.13). As compared with the control group, the weight-lifting group had greater improvements in self-reported severity of lymphedema symptoms (P=0.03) and upper- and lower-body strength (P<0.001 for both comparisons) and a lower incidence of lymphedema exacerbations as assessed by a certified lymphedema specialist (14% vs. 29%, P=0.04). There were no serious adverse events related to the intervention. CONCLUSIONS In breast-cancer survivors with lymphedema, slowly progressive weight lifting had no significant effect on limb swelling and resulted in a decreased incidence of exacerbations of lymphedema, reduced symptoms, and increased strength. (ClinicalTrials.gov number, NCT00194363.).</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Minnesota</li><li>Pennsylvanie</li></region><settlement><li>Philadelphie</li></settlement></list><tree><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Schmitz, Kathryn H" sort="Schmitz, Kathryn H" uniqKey="Schmitz K" first="Kathryn H." last="Schmitz">Kathryn H. Schmitz</name></region><name sortKey="Ahmed, Rehana L" sort="Ahmed, Rehana L" uniqKey="Ahmed R" first="Rehana L." last="Ahmed">Rehana L. Ahmed</name><name sortKey="Bryan, Cathy J" sort="Bryan, Cathy J" uniqKey="Bryan C" first="Cathy J." last="Bryan">Cathy J. Bryan</name><name sortKey="Cheville, Andrea" sort="Cheville, Andrea" uniqKey="Cheville A" first="Andrea" last="Cheville">Andrea Cheville</name><name sortKey="Greene, Quincy P" sort="Greene, Quincy P" uniqKey="Greene Q" first="Quincy P." last="Greene">Quincy P. Greene</name><name sortKey="Lewis Grant, Lorita" sort="Lewis Grant, Lorita" uniqKey="Lewis Grant L" first="Lorita" last="Lewis-Grant">Lorita Lewis-Grant</name><name sortKey="Smith, Rebecca" sort="Smith, Rebecca" uniqKey="Smith R" first="Rebecca" last="Smith">Rebecca Smith</name><name sortKey="Troxel, Andrea" sort="Troxel, Andrea" uniqKey="Troxel A" first="Andrea" last="Troxel">Andrea Troxel</name><name sortKey="Williams Smith, Catherine T" sort="Williams Smith, Catherine T" uniqKey="Williams Smith C" first="Catherine T." last="Williams-Smith">Catherine T. Williams-Smith</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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