The effects of aerobic- versus resistance-based exercise on breast cancer-related lymphoedema

This study will evaluate and compare the effects of aerobic- versus resistance-based exercise to usual care on lymphoedema, lymphoedema-related symptoms (e.g. decreased fitness, impaired functioning, changes in weight, strength loss), and quality of life. Women will be asked to participate in a 12-week intervention (or usual care) and will be assessed pre- and post-intervention and 12 weeks post-intervention. For those in the aerobic-based exercise group, any form of aerobic activity may be undertaken, provided it is at a Rating of Perceived Exertion (RPE) of 11-13 (on a 6-20 scale) for weeks 1-6 and an RPE of 12-14 for weeks 7-12. Sessions will be conducted at location convenient to the participant. During weeks 1-4, there will be 2 supervised sessions a week (50 minutes each), with participants asked to accumulate another 50 minutes of unsupervised exercise (150 minutes total each week). For weeks 5-12, participants will receive 1 supervised session per week (50 minutes) and be asked to achieve an additional 100 minutes unsupervised. All resistance-based exercise sessions will begin with a five-minute cardiovascular warm-up period, followed by a full-body strength training program, including: chest fly, triceps kick-back, squat, curl-ups, bent-over row, bridging, wall push-up, bicep curls, calf raises, shoulder press, external rotation and forward lunge. Modifications will be made at the research’s discretion if pain, injury or altered range of motion prevents proper technique of the given exercise. The same schedule and intensity as the aerobic-based group will be used in the resistance-based group. To monitor adherence, participants in the aerobic- and resistance-based exercise groups will be given activity logs in which to record their weekly, unsupervised exercise, including time, modality and RPE during the session. They will also be asked to record relevant information for exercise sessions (e.g., modifications, pain/discomfort, barriers encountered). At each supervised session over the 12-week intervention, the researcher will review this log with the participant to assess adherence and address any concerns or queries that may arise. The researcher and participant will also schedule days and times during the week when the unsupervised exercise will be undertaken, with identification of an additional ‘back-up’ time period should any barriers arise during any of the selected times. As each program is supervised, this will include discussion of personal barriers and strategies to overcome them, as is traditionally done by exercise physiologists. Verbal praise will be used when participants complete expected unsupervised exercise and given positive encouragement and advice when unsuccessful in meeting the weekly goal. Though 100% adherence is emphasised, individuals will be reminded that an overall adherence of 80%, or 1920 total minutes, over the 12 weeks is the ultimate aim, and if there are weeks they cannot obtain 150 minutes of exercise, they can make up the missed time the following week. Participants in the usual care control group will be called weekly (weeks 1-4) or fortnightly (weeks 5-12) to maintain their interest in the study and ensure they have not increased their exercise participation.