Effects of aerobic cycling training in patients with gynaecologic cancer-related lower extremity lymphedema: A randomised comparative study.

Purpose: Lower extremity lymphedema (LEL) after gynaecological cancer is a chronic disease that affects quality of life and functionality negatively. Exercise therapies help to volume reduction and improved lower extremity functionality and quality of life in patients with lymphedema. However, studies on this subject were mostly focused on upper extremity lymphedema. In this study, we aimed to compare complete decongestive therapy (CDT) and CDT + cycle ergometry in terms of quality of life, lower extremity functionality and volume measurement in patients with gynaecological cancer-related lower extremity lymphedema.

Methods: This study included 63 patients who gave written and verbal informed consent. The participants were randomly divided into two groups as cycling (32 patients) and non-cycling group (31 patients). Demographic and clinical data of patients were recorded. While patients in non-cycling group were treated with only CDT for 3 weeks, patients in cycling group were treated with CDT + cycle ergometry for 3 weeks. Cycle ergometry treatment was performed with Voit AT-200 Black Collection horizontal bike for 20 min. Exercise intensity was adjusted to 40-59% of heart rate reserve (HRR). Volume measurement was evaluated by circumference measurement method, quality of life was evaluated by Lymphedema Quality of Life Questionnaire (LYMQOL) and lower extremity functionality was evaluated by Lower Extremity Functional Scale (LEFS) in all participants.

Result: Both cycling group and non-cycling group benefited from treatments in terms of volume reduction, LEFS and LYMQOL (function, appearance, symptom, mood and overall quality of life) values (p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001 and p < 0.001, respectively). In comparison of cycling and non-cycling groups, significant differences were found in favor of cycling group in terms of delta (Δ) extremity volume values (ml), Δ LEFS, Δ LYMQOL (function, appearance, symptom, mood and overall quality of life) (p = 0.04, p = 0.03, p < 0.001, p = 0.04, p = 0.002, p = 0.002, p < 0.001, p < 0.001 and p = 0.003, respectively). In other words; both groups benefited from treatments in terms of volume reduction, functionality and quality of life. However, benefit of cycling group is greater than benefit of non-cycling group.

Conclusion: Aerobic exercise added to CDT in gynaecological cancer-related lower extremity lymphedema is effective in terms of volume reduction, improved lower extremity functionality and quality of life.

Trial registration: ClinicalTrials.gov Identifier: NCT06200948 .