Association Between Objectively Measured Physical Activity and Lower-Limb Lymphedema Markers in Patients with Lymphedema Secondary to Gynecological Cancer: A Cross-Sectional Study.

Abstract

Background: Lower-limb lymphedema (LLL) secondary to gynecological cancer is a serious health condition that negatively affects physical activity (PA). We investigated the association between objectively measured PA and lymphedema markers in patients with LLL after gynecological cancer treatment. Methods and Results: This cross-sectional study included 56 patients (mean age: 62.0 years) with LLL attending a lymphedema center. The degree of lymphedema was evaluated based on lower-limb water content (extracellular water content/whole body water content: ECW/TBW). The amount and intensity of PA were measured using an accelerometer. Thirty-three patients (61.1%) with ECW/TBW ≥0.4 were older, had significantly more sedentary time, and spent lesser time on moderate-to-vigorous activity than patients with ECW/TBW <0.4 (p < 0.05). A generalized linear model using the rate of change in ECW/TBW showed an association with older age, longer time since cancer diagnosis, and lower activity level. The severity of subjective symptoms measured using a visual analog scale did not differ between patients with high and low ECW/TBW. Conclusions: Patients with LLL spent approximately half of the time in sedentary behavior, with more severe cases exhibiting longer sedentary durations. In older patients who have a long-standing cancer diagnosis, medical professionals should evaluate their activity and self-care status in addition to evaluating LLL and use this information to provide individualized interventions.