Wittenkamp Merete Celano, Christensen Jan, Vinther Anders, Juhl Carsten Bogh
Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmar; Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital - Rigshospitalet, Denmark.
Acta Oncol. 2025 Mar 31;64:484-498. doi: 10.2340/1651-226X.2025.42560.
To summarize the evidence of the immediate and long-term effect of exercise interventions in patients with either primary or secondary lower limb lymphedema (LLL) on health-related quality of life (HR-QOL), physical function, self-reported symptoms, lower limb volume, and adverse events.
Systematic review following the guidelines from the Cochrane Handbook of Systematic Reviews of Interventions.
MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), and clinicaltrials.gov.
Prospective exercise trials investigating exercise interventions as a single- or multicomponent programme in patients with LLL including assessment of at least one of the following outcomes: HR-QOL, self-reported LLL symptoms (heaviness, tension, and pain), physical function, or lower limb volume. Randomized controlled trials (RCTs), single-group studies, and cross-over trials were eligible. Trials with participants at risk of LLL or a diagnosis of filariasis or lipedema were excluded.
Twelve studies were included: three RCTs, five single-group studies, and four cross-over trials with a total of three hundred and sixty-seven participants. In patients with LLL, irrespective of severity, exercise seemed to have small but positive effects on HR-QOL, physical function, pain, and lower limb volume. Quality assessment showed high risk of bias. Large heterogeneity in participants, interventions, and outcome measures hinders performing of meta-analyses.
Based on a small number of studies with large clinical heterogeneity, poor methodological quality, hence low level of certainty of evidence, it was not possible to provide evidence-based recommendations on exercise for patients with LLL.
总结运动干预对原发性或继发性下肢淋巴水肿（LLL）患者的近期和长期影响，这些影响涉及健康相关生活质量（HR-QOL）、身体功能、自我报告的症状、下肢体积和不良事件。
按照《Cochrane系统评价干预措施手册》的指南进行系统评价。
MEDLINE、EMBASE、CINAHL、Cochrane对照试验中央注册库（CENTRAL）和clinicaltrials.gov。
前瞻性运动试验，将运动干预作为单一或多组分方案，用于LLL患者，包括评估以下至少一项结果：HR-QOL、自我报告的LLL症状（沉重感、紧张感和疼痛）、身体功能或下肢体积。随机对照试验（RCT）、单组研究和交叉试验均符合要求。排除有LLL风险参与者或诊断为丝虫病或脂肪性水肿的试验。
纳入12项研究：3项RCT、5项单组研究和4项交叉试验，共367名参与者。在LLL患者中，无论严重程度如何，运动似乎对HR-QOL、身体功能、疼痛和下肢体积有微小但积极的影响。质量评估显示存在高偏倚风险。参与者、干预措施和结局测量的高度异质性阻碍了荟萃分析的进行。
基于少量临床异质性大、方法学质量差且证据确定性低的研究，无法为LLL患者提供基于证据的运动建议。
