Kara Onur, Mete Civelek Gül, Şahbaz Pirinççi Cansu, Tarlabölen Rabia, Dalyan Meltem
Health Sciences University, Ankara Bilkent City Hospital, Physical Therapy and Rehabilitation Hospital, 06800, Çankaya, Ankara, Turkey.
Osmaniye Devlet Hastanesi, 80020, Merkez, Osmaniye, Turkey.
Support Care Cancer. 2025 Mar 19;33(4):302. doi: 10.1007/s00520-025-09354-4.
Lower extremity lymphedema (LEL) after gynaecological cancer is a chronic disease that affects quality of life and functionality negatively. Exercise therapies help to volume reduction and improved lower extremity functionality and quality of life in patients with lymphedema. However, studies on this subject were mostly focused on upper extremity lymphedema. In this study, we aimed to compare complete decongestive therapy (CDT) and CDT + cycle ergometry in terms of quality of life, lower extremity functionality and volume measurement in patients with gynaecological cancer-related lower extremity lymphedema.
This study included 63 patients who gave written and verbal informed consent. The participants were randomly divided into two groups as cycling (32 patients) and non-cycling group (31 patients). Demographic and clinical data of patients were recorded. While patients in non-cycling group were treated with only CDT for 3 weeks, patients in cycling group were treated with CDT + cycle ergometry for 3 weeks. Cycle ergometry treatment was performed with Voit AT-200 Black Collection horizontal bike for 20 min. Exercise intensity was adjusted to 40-59% of heart rate reserve (HRR). Volume measurement was evaluated by circumference measurement method, quality of life was evaluated by Lymphedema Quality of Life Questionnaire (LYMQOL) and lower extremity functionality was evaluated by Lower Extremity Functional Scale (LEFS) in all participants.
Both cycling group and non-cycling group benefited from treatments in terms of volume reduction, LEFS and LYMQOL (function, appearance, symptom, mood and overall quality of life) values (p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001 and p < 0.001, respectively). In comparison of cycling and non-cycling groups, significant differences were found in favor of cycling group in terms of delta (Δ) extremity volume values (ml), Δ LEFS, Δ LYMQOL (function, appearance, symptom, mood and overall quality of life) (p = 0.04, p = 0.03, p < 0.001, p = 0.04, p = 0.002, p = 0.002, p < 0.001, p < 0.001 and p = 0.003, respectively). In other words; both groups benefited from treatments in terms of volume reduction, functionality and quality of life. However, benefit of cycling group is greater than benefit of non-cycling group.
Aerobic exercise added to CDT in gynaecological cancer-related lower extremity lymphedema is effective in terms of volume reduction, improved lower extremity functionality and quality of life.
ClinicalTrials.gov Identifier: NCT06200948 .
妇科癌症后下肢淋巴水肿（LEL）是一种慢性疾病，对生活质量和功能有负面影响。运动疗法有助于减轻淋巴水肿患者的下肢体积，改善下肢功能和生活质量。然而，关于这一主题的研究大多集中在上肢淋巴水肿。在本研究中，我们旨在比较完全减压疗法（CDT）和CDT联合循环测力计训练在妇科癌症相关下肢淋巴水肿患者的生活质量、下肢功能和体积测量方面的效果。
本研究纳入63例签署书面和口头知情同意书的患者。参与者被随机分为两组，即骑行组（32例患者）和非骑行组（31例患者）。记录患者的人口统计学和临床数据。非骑行组患者仅接受3周的CDT治疗，而骑行组患者接受3周的CDT联合循环测力计训练。使用Voit AT-200 Black Collection卧式自行车进行20分钟的循环测力计训练。运动强度调整为心率储备（HRR）的40-59%。通过周长测量法评估体积，通过淋巴水肿生活质量问卷（LYMQOL）评估生活质量，通过下肢功能量表（LEFS）评估所有参与者的下肢功能。
骑行组和非骑行组在体积减小、LEFS和LYMQOL（功能、外观、症状、情绪和总体生活质量）值方面均从治疗中获益（p均<0.001）。在骑行组和非骑行组的比较中，发现骑行组在肢体体积变化值（ml）、ΔLEFS、ΔLYMQOL（功能、外观、症状、情绪和总体生活质量）方面有显著优势（p分别为0.04、0.03、<0.001、0.04、0.002、0.002、<0.001、<0.001和0.003）。换句话说，两组在体积减小、功能和生活质量方面均从治疗中获益。然而，骑行组的获益大于非骑行组。
在妇科癌症相关下肢淋巴水肿中，将有氧运动添加到CDT中在体积减小、改善下肢功能和生活质量方面是有效的。
ClinicalTrials.gov标识符：NCT06200948 。
