Wang Ling, Shi Yue Xian, Wang Ting Ting, Chen Ke Xin, Shang Shao Mei
School of Nursing, Peking University, Beijing, China.
School of Nursing, Wannan Medical College, Wuhu, China.
J Clin Nurs. 2023 May;32(9-10):2208-2227. doi: 10.1111/jocn.16437. Epub 2022 Jul 27.
Breast cancer-related lymphoedema (BCRL) is a side effect of cancer treatment and can be alleviated by resistance exercise. This systematic, evidence-based review examined the existing best evidence on resistance exercise for BCRL to accurately describe the current status of the field and offer recommendations for clinicians.
This review adheres to the PRISMA guidelines. Clinical practice guidelines, consensus documents, systematic reviews and other related evidence-based resources about resistance exercise for BCRL were retrieved through the English databases and guideline websites. The publication data limit was set to December 2020. The following search terms were used: 'breast cancer/breast neoplasm/breast carcinoma/breast tumor/breast malignancy, lymphedema/swelling/edema/lymphoedema, resistance/weight/strength training, best practice/clinical practice/guideline/consensus documents'. The quality of the included studies was evaluated by two authors independently using AGREE II and AMSTAR II tools. Evidence-based recommendations on resistance exercise relevant for BCRL were synthesised and categorised.
Twenty two articles (seven guidelines, four consensus documents and eleven systematic reviews) were included. The overall quality of the eleven eligible guidelines and consensus documents was moderate to high according to the AGREE II criteria. The quality of the eleven systematic reviews was critically low to high according to the AMSTAR criteria. Six clinical topics involving 43 recommendations were identified. Recommendations were categorised by safety of resistance training, effectiveness of resistance training, evaluation prior to resistance exercise, resistance exercise prescription, resistance training outcome index and points for attention.
This study summarises 43 recommendations for resistance training for BCRL and provides guidance for clinicians. Based on randomised trials and systematic reviews published in recent years, there is an urgent need to update the guidelines and consensus documents in terms of topics, for example effectiveness of resistance training and resistance training outcome index.
乳腺癌相关淋巴水肿（BCRL）是癌症治疗的一种副作用，可通过抗阻运动得到缓解。本项基于证据的系统性综述，审视了关于BCRL抗阻运动的现有最佳证据，以准确描述该领域的当前状况，并为临床医生提供建议。
本综述遵循PRISMA指南。通过英文数据库和指南网站检索了有关BCRL抗阻运动的临床实践指南、共识文件、系统性综述及其他相关循证资源。出版数据限制设定为2020年12月。使用了以下检索词：“乳腺癌/乳腺肿瘤/乳腺癌/乳腺肿瘤/乳腺恶性肿瘤，淋巴水肿/肿胀/水肿/淋巴水肿，抗阻/重量/力量训练，最佳实践/临床实践/指南/共识文件”。两名作者独立使用AGREE II和AMSTAR II工具评估纳入研究的质量。综合并分类了与BCRL相关的抗阻运动循证建议。
纳入了22篇文章（7篇指南、4篇共识文件和11篇系统性综述）。根据AGREE II标准，11篇合格指南和共识文件的总体质量为中等至高。根据AMSTAR标准，11篇系统性综述的质量从极低到高不等。确定了涉及43条建议的6个临床主题。建议按抗阻训练的安全性、抗阻训练的有效性、抗阻运动前的评估、抗阻运动处方、抗阻训练结果指标和注意事项进行分类。
本研究总结了43条BCRL抗阻训练建议，为临床医生提供了指导。基于近年来发表的随机试验和系统性综述，迫切需要在主题方面更新指南和共识文件，例如抗阻训练的有效性和抗阻训练结果指标。
