Lymphology Association of North America (LANA) Practice Exam

Which statement is false regarding exercise for patients with breast cancer-related lymphedema (BCRL)?

1. Supervised, slow progressive weight training is encouraged.

2. Compression garments must be worn with aquatic exercise.

3. Diaphragmatic breathing will assist lymphatic transport.

4. Lymphedema may be aggravated by high intensity aerobic exercises.

The correct answer is: Compression garments must be worn with aquatic exercise.

The statement that compression garments must be worn with aquatic exercise is false. While it is generally recommended that patients with breast cancer-related lymphedema (BCRL) use compression garments during various forms of exercise to support lymphatic drainage and prevent exacerbation of lymphedema, aquatic exercise presents a unique scenario. The buoyant properties of water can alleviate the pressure on the lymphatic system and allow for greater lymphatic transport. In many cases, patients are advised that the hydrostatic pressure of water is sufficient to support their lymphedema management without necessitating the use of compression garments during exercise in the water, making this statement misleading. The other statements regarding exercise for patients with BCRL are supported by evidence and practice guidelines. Supervised, slow progressive weight training can help patients improve strength and function without increasing lymphedema risk when done appropriately. Diaphragmatic breathing is known to enhance lymphatic flow and can be beneficial during exercise. Additionally, high-intensity aerobic exercises may pose a risk of exacerbating lymphedema by increasing the overall metabolic demand and fluid accumulation, especially if not managed with care.