Breast Cancer Research and Treatment

, Volume 148, Issue 2, pp 249–268 | Cite as

Safety and efficacy of progressive resistance training in breast cancer: a systematic review and meta-analysis

  • Birinder S. CheemaEmail author
  • Sharon L. Kilbreath
  • Paul P. Fahey
  • Geoffrey P. Delaney
  • Evan Atlantis


The purpose of this study was to assess the safety and efficacy of progressive resistance training (PRT) in breast cancer. Randomized controlled trials (RCTs) published to November 2013 that reported on the effects of PRT (>6 weeks) on breast cancer-related lymphedema (BCRL) (incidence/exacerbation, arm volume, and symptom severity), physical functioning (upper and lower body muscular strength), and health-related quality of life (HRQoL) in breast cancer patients were included. Of 446 citations retrieved, 15 RCTs in 1,652 patients were included and yielded five studies on BCRL incidence/exacerbation (N = 647), four studies on arm volume (N = 384) and BCRL symptom severity (N = 479), 11 studies on upper body muscular strength (N = 1,252), nine studies on lower body muscular strength (N = 1,079), and seven studies on HRQoL (N = 823). PRT reduced the risk of BCRL versus control conditions [OR = 0.53 (95 % CI 0.31–0.90); I 2 = 0 %] and did not worsen arm volume or symptom severity (both SMD = −0.07). PRT significantly improved upper [SMD = 0.57 (95 % CI 0.37–0.76); I 2 = 58.4 %] and lower body muscular strength [SMD = 0.48 (95 % CI 0.30–0.67); I 2 = 46.7 %] but not HRQoL [SMD = 0.17 (95 % CI −0.03 to 0.38); I 2  = 47.0 %]. The effect of PRT on HRQoL became significant in our sensitivity analysis when two studies conducted during adjuvant chemotherapy [SMD = 0.30 (95 % CI 0.04–0.55), I 2 = 37.0 %] were excluded. These data indicate that PRT improves physical functioning and reduces the risk of BCRL. Clinical practice guidelines should be updated to inform clinicians on the benefits of PRT in this cohort.


Strength Physical functioning Quality of life Rehabilitation Exercise Health Lymphedema Survival Fitness 



We sincerely thank Ms Katrina Chaudhary for her work in developing the database searches.


All authors have completed the ICMJE uniform disclosure form at and declare: no support from any organization for the submitted work.

Conflict of interest

The authors declare that they have no competing interests.

Supplementary material

10549_2014_3162_MOESM1_ESM.docx (68 kb)
Supplementary material 1 (DOCX 68 kb)


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Birinder S. Cheema
    • 1
    • 2
    Email author
  • Sharon L. Kilbreath
    • 3
  • Paul P. Fahey
    • 1
  • Geoffrey P. Delaney
    • 4
    • 5
    • 6
  • Evan Atlantis
    • 7
    • 8
  1. 1.School of Science and HealthUniversity of Western SydneyPenrithAustralia
  2. 2.The National Institute of Complementary MedicinePenrithAustralia
  3. 3.Faculty of Health SciencesUniversity of SydneyLidcombeAustralia
  4. 4.Ingham Institute for Applied Medical ResearchLiverpoolAustralia
  5. 5.South Western Sydney Clinical SchoolUniversity of New South WalesSydneyAustralia
  6. 6.Liverpool HospitalLiverpoolAustralia
  7. 7.School of Nursing and MidwiferyUniversity of Western SydneyPenrithAustralia
  8. 8.School of MedicineUniversity of AdelaideAdelaideAustralia

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