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

• Published in: Breast cancer research and treatment Vol. 148; no. 2; pp. 249 - 268
• Main Authors: Cheema, Birinder S., Kilbreath, Sharon L., Fahey, Paul P., Delaney, Geoffrey P., Atlantis, Evan
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01-11-2014; Springer; Springer Nature B.V
• Subjects: Adjuvant treatment; Analysis; Breast cancer; Breast Neoplasms - rehabilitation; Cancer; Cancer research; Cancer therapies; Exercise Therapy; Female; Humans; Medicine; Medicine & Public Health; Meta-analysis; Oncology; Quality of Life; Randomized Controlled Trials as Topic; Resistance to control; Resistance Training; Review; Safety; Weight training; Exercise; Lymphedema; Health; Physical functioning; Rehabilitation; Survival; Strength; Quality of life; Fitness
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-014-3162-9

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.