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

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Abstract

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.

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Acknowledgments

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

Funding

All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/coi_disclosure.pdf and declare: no support from any organization for the submitted work.

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The authors declare that they have no competing interests.

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Authors and Affiliations

  1. School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith, NSW, 2751, Australia

    Birinder S. Cheema & Paul P. Fahey

  2. The National Institute of Complementary Medicine, Penrith, NSW, 2751, Australia

    Birinder S. Cheema

  3. Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, 1825, Australia

    Sharon L. Kilbreath

  4. Ingham Institute for Applied Medical Research, Liverpool, NSW, 2170, Australia

    Geoffrey P. Delaney

  5. South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, 2052, Australia

    Geoffrey P. Delaney

  6. Liverpool Hospital, Liverpool, NSW, 2170, Australia

    Geoffrey P. Delaney

  7. School of Nursing and Midwifery, University of Western Sydney, Penrith, NSW, 2751, Australia

    Evan Atlantis

  8. School of Medicine, University of Adelaide, Adelaide, SA, 5000, Australia

    Evan Atlantis

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Correspondence to Birinder S. Cheema.

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Cheema, B.S., Kilbreath, S.L., Fahey, P.P. et al. Safety and efficacy of progressive resistance training in breast cancer: a systematic review and meta-analysis. Breast Cancer Res Treat 148, 249–268 (2014). https://doi.org/10.1007/s10549-014-3162-9

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