Effectiveness of Home-Based Progressive Resistance Exercise in the Management of Breast Cancer-Related Lymphedema: A Randomized Controlled Trial

Abstract

Background/Objectives: Resistance exercise is considered safe in breast cancer-related lymphedema (BCRL), but its efficacy as an adjunct to standard decongestive care in women with established lymphedema is uncertain, and sleep quality is rarely assessed. This trial evaluated a home-based progressive resistance exercise programme in this population. Methods: Fifty women with unilateral upper-limb BCRL were randomly allocated (1:1) to exercise or control groups. Both groups received classic lymphedema physiotherapy twice weekly for 12 weeks; the exercise group additionally performed eight upper-limb exercises (three sets of ten repetitions, elastic resistance progressed every four weeks) twice weekly at home. The primary outcome was the percentage of excess limb volume derived from circumferential measurements. Assessors were blinded; groups were compared by analysis of covariance adjusted for baseline values. Results: Forty-six participants (92%) completed follow-up; adherence was 91.7% and no adverse events occurred. Excess limb volume decreased more in the exercise group (adjusted difference −2.04 percentage points, 95% CI −3.99 to −0.10; p = 0.040; d = 0.61), a finding robust in intention-to-treat and age-adjusted analyses. Handgrip strength and the LYMQOL function domain also favoured the exercise group, but no secondary outcome survived Holm–Bonferroni correction. Sleep quality improved comparably in both groups (p = 0.629). Conclusions: Home-based progressive resistance exercise added to lymphedema physiotherapy reduced excess limb volume, with a moderate effect and no adverse events, although the absolute between-group difference was small and its clinical importance uncertain. Sleep quality did not improve differentially and may require targeted intervention.