Effectiveness of Physical Exercise Programs in Reducing Secondary Lymphedema Associated with Breast Cancer: An Overview of Systematic Reviews
In brief
Supervised weightlifting cuts risk of lymphedema swelling increase by roughly 87%
A review of randomized trials found that women with breast-cancer-related lymphedema who performed supervised weightlifting were far less likely to experience a at least 5% rise in arm volume, with about one in eight the risk of usual care. Aquatic exercise also modestly improved shoulder range, but overall evidence quality remains low and safety reporting is incomplete.
- Journal
- Journal of clinical medicine (Q1)
- Published
- 26 June 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Raúl Alberto Aguilera-Eguía, Carlos Zaror, Ruvistay Gutiérrez-Arias, Héctor Fuentes-Barria, Olga Patricia López-Soto, Cherie Flores-Fernández, et al.
- PMID
- 42452464
- DOI
- 10.3390/jcm15135001
Why clinicians should know about it
- Picked for Rehabilitation (top studies of the week, 19 July 2026).
Abstract
Introduction: Breast cancer-related lymphedema (BCRL) is a disabling complication, and the effectiveness of exercise as treatment remains uncertain. Objective: We aimed to evaluate the effectiveness and safety of exercise in women with BCRL. Methods: A comprehensive search was conducted in MEDLINE, Embase, Cochrane Library, PEDro, and LILACS from database inception to March 2025, collating systematic reviews (SRs) of randomized controlled trials (RCTs) evaluating exercise, alone or combined with physiotherapy, in women with BCRL. Risk of bias was assessed using ROBIS and RoB 2, certainty of evidence (CoE) using GRADE, and overlap using GROOVE. Results: Of 2023 records, 9 SRs including 170 primary studies were included; after overlap management, eligible RCT data were synthesized by comparison and outcome. Supervised weightlifting probably reduced the risk of a ≥5% long-term increase in lymphedema volume (RR: 0.13; 95% CI: 0.07-0.25; moderate CoE), but evidence is very uncertain regarding ≥5% volume reduction (RR: 0.85; 95% CI: 0.44-1.66; very low CoE). Aquatic exercise may improve shoulder flexion (MD: 8.73 degrees; 95% CI: 3.55-13.91; low CoE) and shoulder abduction (MD: 6.87 degrees; 95% CI: 2.50-11.24; low CoE) compared with Pilates. No adverse events were reported, although they were not systematically defined or reported. Conclusions: Supervised weightlifting probably prevents increases in lymphedema volume, and aquatic exercise may improve shoulder mobility; however, the evidence remains uncertain, and the absence of adverse events does not confirm safety. Registration: PROSPERO (CRD42022334433).
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.