McClure, M.K., McClure, R.J., Day, R., & Brufsky, A.M. (2010). Randomized controlled trial of the Breast Cancer Recovery Program for women with breast cancer-related lymphedema. The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association, 64(1), 59–72.

To determine effect of completion of a recovery program including gentle exercise and deep breathing on breast cancer-related lymphedma

Patients assigned to the treatment group attended biweekly one-hour exercise and educational sessions for five weeks, then followed a three-month self-monitored home program. Those in the treatment group were instructed to complete use of a video and relaxation daily at home. Exercises included gravity-resistive arm movements incorporating shoulder flexion, abduction, and external rotation. Exercise and compression hose adherence was assessed with a self-report tool designed for the study. Control patients received usual care. Patients were assigned into four groups of treatment and controls.

The study sample (N = 32) was comprised of female patients aged 21–80 years with stage I or II unilateral breast cancer-related lymphedema.

The study took place in an outpatient site in Pittsburgh, PA.

The study used a randomized controlled single blind trial design.

• Bioimpedance differences were compared between the affected and unaffected arm.
• The Beck Depression Inventory measured severity of depression.
• The 36-Item Short Form Health Survey (SF-36) measured quality of life.
• Cone girth was measured.

Bioimpedance mean differences of those in treatment compared with controls showed a positive main effect for treatment (p = 0.049). There was no significant effect on volume measures. Patients who complied with compression demonstrated improvement over time. Range of motion, mood, and quality of life improved in those in the treatment group.

The program of combined exercise activity and self-directed practice related to coping and relaxation were associated with improvement in lymphedema and other symptoms.

• The sample size was small (N < 100).
• The study had no attentional control.
• Limited information is provided regarding all aspects of the intervention.
• Lack of participant binding poses potential for patient self-report measures.

Findings support the positive benefit of patient upper-extremity exercises in the management of lymphedema.