Safety of Weightlifting Among Women with or at Risk for Breast Cancer–Related Lymphedema: Musculoskeletal Injuries and Health Care Use in a Weightlifting Rehabilitation Trial

Abstract

Abstract Learning Objectives After completing this course, the reader will be able to: Elucidate the risk-to-benefit relationship of prescribing weightlifting to breast cancer survivors with or at risk for lymphedema.Identify the frequency and describe common musculoskeletal injuries and health care needs of breast cancer survivors that may require dose modification or cessation of weightlifting exercise.Identify the need for trained exercise professionals prepared with the knowledge and skills to encounter the musculoskeletal and health care needs of breast cancer survivors engaging in weightlifting exercise. CME This article is available for continuing medical education credit at CME.TheOncologist.com Introduction. It has been noted that only 14% of all clinical trials are translated into practice. The objective of this paper is to promote translation of an efficacious rehabilitative exercise program for breast cancer survivors by clarifying for clinicians the safety profile of participants (e.g., rates of musculoskeletal injury and referral to medical professionals), and to use this evidence to make recommendations on the appropriate training of health and fitness staff who would be capable of safely, effectively, and sustainably delivering the program. Methods. Breast cancer survivors with and at risk for lymphedema were randomized to twice-weekly weightlifting or standard care for 1 year. An injury survey and health care evaluation were administered after 1 year and in 3-month intervals, respectively. Results. The cumulative incidence and rate of injury were higher in the weightlifting than in the control group. The injury rates were 2.3 and 0.3 per 1,000 bouts of weightlifting among breast cancer survivors with and at risk for lymphedema, respectively. Among breast cancer survivors with or at risk for lymphedema, 20.9% in the weightlifting group had an encounter with a health care provider that required cessation or dose modification of weightlifting. Conclusion. Despite the demonstrated efficacy of weightlifting, musculoskeletal injuries and other health problems did occur. Therefore, for the successful translation of this rehabilitative intervention into clinical practice, health and fitness professionals working with breast cancer survivors need the knowledge, skills, and abilities that clarify their scope of practice to address these health care needs.