Abstract：
OBJECTIVE: A systematic review investigated the effectiveness of physical activity in alleviating lower limb lymphedema among patients with gynecological cancer after surgery.
METHODS: A systematic review of randomized controlled trials and quasi-experimental designs was conducted. Six databases, Cinahl, Cochrane, Embase, Medline, Scopus, and Web of Science, were searched for relevant publications from inception to October 2022 and updated in January 2024. RevMan software was used to perform meta-analysis using a random-effects model.
RESULTS: Seven studies (5 randomized controlled trials) containing 261 subjects were synthesized. The risk of bias was low in the included studies. The exercise interventions for lower limb lymphedema included active, aerobic, aquatic, and weight-lifting exercises. Meta-analyses showed that active exercise had no effect on lymphedema symptoms of limb volume, pain, and heaviness. However, the effectiveness of exercise on limb volume had subthreshold borderline significance in 2 studies (standardized mean difference = 0.43, 95% confidence interval - 0.01, 0.88; I2 = 0%, p = 0.06). Three studies found that lymphedema symptoms were significantly improved after exercise interventions. The adherence rate of the exercise was 77-100%, with the only complication being cellulitis.
CONCLUSIONS: Although the meta-analysis does not reveal a significant effect, the systematic review study demonstrated that exercise is feasible, safe, and has a clinical effect on alleviating lymphedema-related symptoms of women following gynecological cancer surgery.
METHODS: A systematic review of randomized controlled trials and quasi-experimental designs was conducted. Six databases, Cinahl, Cochrane, Embase, Medline, Scopus, and Web of Science, were searched for relevant publications from inception to October 2022 and updated in January 2024. RevMan software was used to perform meta-analysis using a random-effects model.
RESULTS: Seven studies (5 randomized controlled trials) containing 261 subjects were synthesized. The risk of bias was low in the included studies. The exercise interventions for lower limb lymphedema included active, aerobic, aquatic, and weight-lifting exercises. Meta-analyses showed that active exercise had no effect on lymphedema symptoms of limb volume, pain, and heaviness. However, the effectiveness of exercise on limb volume had subthreshold borderline significance in 2 studies (standardized mean difference = 0.43, 95% confidence interval - 0.01, 0.88; I2 = 0%, p = 0.06). Three studies found that lymphedema symptoms were significantly improved after exercise interventions. The adherence rate of the exercise was 77-100%, with the only complication being cellulitis.
CONCLUSIONS: Although the meta-analysis does not reveal a significant effect, the systematic review study demonstrated that exercise is feasible, safe, and has a clinical effect on alleviating lymphedema-related symptoms of women following gynecological cancer surgery.
摘要：
目的：系统评价了体力活动对减轻妇科肿瘤患者术后下肢淋巴水肿的作用。
方法：对随机对照试验和准实验设计进行了系统评价。六个数据库,Cinahl,科克伦,Embase,Medline,Scopus,和WebofScience,从成立到2022年10月，在2024年1月进行了相关出版物的搜索。RevMan软件用于使用随机效应模型进行荟萃分析。
结果：共7项研究（5项随机对照试验）纳入261名受试者。纳入研究的偏倚风险较低。下肢淋巴水肿的运动干预措施包括积极，有氧,水生,和举重练习。Meta分析显示,积极运动对肢体体积的淋巴水肿症状无影响,疼痛,和沉重。然而,在2项研究中，运动对肢体体积的有效性具有阈值下的临界意义（标准化平均差=0.43，95％置信区间-0.01，0.88；I2=0％，p=0.06)。三项研究发现，运动干预后淋巴水肿症状明显改善。锻炼的依从率为77-100%,唯一的并发症是蜂窝织炎.
结论：尽管荟萃分析并未显示出明显的效果，系统回顾研究表明，锻炼是可行的，安全,对缓解妇科肿瘤术后淋巴水肿相关症状有临床疗效。
方法：对随机对照试验和准实验设计进行了系统评价。六个数据库,Cinahl,科克伦,Embase,Medline,Scopus,和WebofScience,从成立到2022年10月，在2024年1月进行了相关出版物的搜索。RevMan软件用于使用随机效应模型进行荟萃分析。
结果：共7项研究（5项随机对照试验）纳入261名受试者。纳入研究的偏倚风险较低。下肢淋巴水肿的运动干预措施包括积极，有氧,水生,和举重练习。Meta分析显示,积极运动对肢体体积的淋巴水肿症状无影响,疼痛,和沉重。然而,在2项研究中，运动对肢体体积的有效性具有阈值下的临界意义（标准化平均差=0.43，95％置信区间-0.01，0.88；I2=0％，p=0.06)。三项研究发现，运动干预后淋巴水肿症状明显改善。锻炼的依从率为77-100%,唯一的并发症是蜂窝织炎.
结论：尽管荟萃分析并未显示出明显的效果，系统回顾研究表明，锻炼是可行的，安全,对缓解妇科肿瘤术后淋巴水肿相关症状有临床疗效。
