Effect of Yoga Among Women at Risk and With Breast Cancer–Related Lymphedema: A Systematic Review

Background: Participation in exercise improves function, restores fitness, and enhances quality of life in survivors of breast cancer. There is robust evidence regarding resistance and aerobic training for women at risk for and with breast cancer–related lymphedema; however, the effect of yoga on impairments and functional outcomes has not been well documented. The purpose of this systematic review is to examine the effect of yoga on arm volume, strength, range of motion, function, and quality of life among women at risk for and with breast cancer–related lymphedema and create evidence-based recommendations. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (Prospero registration number: 42022311574). EMBASE, PubMed, CINAHL Complete, Web of Science, Scopus, and Google Scholar were searched from January 2010 through December 2021. Quality and bias of included studies were assessed using the American Physical Therapy Association's Critical Appraisal Tool for Experimental Intervention Studies. Results: A total of 132 articles were screened for eligibility and 9 studies met inclusion criteria. Based on 3 acceptable and 6 low-quality studies, this review found that participation in yoga demonstrated a positive effect on arm range of motion, strength, function, and quality of life among women at risk for and with breast cancer–related lymphedema. No safety issues, including new onset or exacerbation of lymphedema, were found in the reviewed studies. Conclusion: Integration of yoga into a therapeutic plan of care is supported. Variations in yoga type, mode, duration, and frequency currently make it challenging to generate specific guidelines. Adherence and an ongoing commitment to yoga practice may promote long-term effects.