Decongestive progressive resistance exercise with an adjustable compression wrap for breast cancer-related lymphoedema (DREAM): protocol for a randomised controlled trial

Mona M Al Onazi, Kristin L Campbell, Richard B Thompson, Sunita Ghosh, John R Mackey, Anne Muir, Margaret L McNeely, Mona M Al Onazi, Kristin L Campbell, Richard B Thompson, Sunita Ghosh, John R Mackey, Anne Muir, Margaret L McNeely

Abstract

Introduction: Breast cancer-related lymphoedema (BCRL) is a chronic swelling in the arm on the side of the breast cancer surgery, affecting one in five women. Recent studies in BCRL have demonstrated that resistance exercise can improve symptoms and quality of life without worsening lymphoedema. No studies have explored whether combining the principles of progressive resistance exercise training with therapeutic strategies of compression therapy and the decongestive lymphatic exercise sequence are beneficial in reducing arm lymphoedema volume. The aim of this three-arm, provincial randomised controlled trial is to determine the efficacy of a 12-week decongestive progressive resistance exercise (DRE) programme in combination with the one of two types of compression garments compared with standard care.

Methods and analysis: Sixty women with BCRL will be recruited and randomly assigned to one of the following three groups: (1) Standard care, (2) DRE with use of a daytime compression garment during exercise and (3) DRE with use of an adjustable compression wrap during exercise. The primary outcome is the percentage reduction in arm lymphoedema volume. Secondary outcomes include bioimpedance analysis, muscular strength, shoulder range of motion, physical activity level and health-related quality of life. Exploratory outcomes include evaluating changes in arm tissue composition using MRI and examining outcomes between the two DRE experimental groups. The primary analysis will compare changes between the groups from baseline to week 12 reflecting the end of the randomised control trial period.

Ethics and dissemination: The trial has received ethics approval from the Health Research Ethics Board of Alberta: Cancer Committee. The study results will be disseminated through scientific peer-reviewed publications, and presented at national and international conferences, and other media portals. The programme protocol will be shared with healthcare professionals and patient groups through clinical workshops and webinars.

Trial registration number: NCT05022823.

Protocol version: 12 November 2021.

Issue date: 26 April 2021.

Keywords: Adult oncology; Breast tumours; COMPLEMENTARY MEDICINE; Rehabilitation medicine.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Schematic of the theoretical concept—combined decongestive progressive resistance exercise (DRE) and compression therapy.
Figure 2
Figure 2
Study schema. BIRS, Body Image and Relationships Scale; DRE, decongestive resistance exercise; GLTEQ, Godin Leisure-Time Exercise Questionnaire; Lymph-ICF, Lymphoedema Functioning, Disability and Health; ROM, range of motion; SF-36, Short Form-36 Version 2.
Figure 3
Figure 3
MRI—one sample slice.

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