The adverse impact of strenuous exercise on breast cancer-related lymphoedema: A case report
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Background: Exercise is an essential part of lymphoedema treatment; however, it's important to consider the level of exercise intensity in lymphoedema patients. Aim: To examine the effects of one session of strong exercise, which included extreme weight-bearing to the limb affected by lymphoedema. Methods: A 66-year-old female patient with breast cancer-related lymphoedema (BCRL) attended the oncological rehabilitation unit in May 2012. The patient was evaluated and trained about prevention and control methods for lymphoedema. She then entered a routine exercise programme that included range-of-motion, proprioceptive neuromuscular facilitation, posture and breathing exercises. In addition, she attempted to perform non-prescribed exercises that she saw on television; after this, she reported feeling that the exercises were difficult for her arm. After completing the exercises, she recorded by self-measurement that the lymphoedema increased. She then re-attended our unit for advice and was re-evaluated. Results: The summated difference of circumference measurements between the upper extremities increased from 9.3cm to 17.7cm. The increases were greater than 2cm at five of 11 locations. Conclusions: One session or inappropriate and unadvised exercise intervention can increase arm circumference and volume. Ideally, any exercise programme should be administered and overseen by a professional familiar with lymphoedema, who must consider the principle of the individuality of exercise. Further frequent checks of outcomes should be performed. Only a thorough assessment can guide the selection of the most suitable exercise programme, and educate about the dangers of difficult activities to reduce the risk of exacerbation of lymphoedema.