Lymphedema; Lymphatic system; Aerobic exercises; Isometric exercise; Skin--Care and hygiene; Cancer; Exercise therapy


Recent research has shown that most individuals with secondary lymphedema can safely engage in aerobic, resistive, and flexibility type exercises during Complete Decongestive Therapy (CDT) phase 2; however, adherence to exercise remains low for this population. Since lymphedema is a chronic disorder, strict adherence to CDT phase 2, or self-management of symptoms, is necessary. In general, it appears difficult for individuals to adhere to all components of CDT phase 2, namely wearing of the compression garment, nail and skin care, manual lymphatic drainage, and exercise. The current study sought to explore factors influencing follow through with the exercise routine prescribed by the lymphedema therapist and the level of involvement in other physical activities. All individuals with secondary lymphedema, 12-15 months post-initial evaluation, from 2 local lymphedema clinics were invited to participate in this study. A survey was developed to gather descriptive information on the participants as well as examine the client and clinical factors associated with participants’ adherence to a prescribed exercise routine. Eight individuals returned the survey, four with lymphedema in the bilateral lower extremities (LEs), one unilateral LE, two unilateral upper extremities (UEs), and one groin. The most common cause of lymphedema was cancer, however, infection, surgery, trauma, and disease were also causes present in this study. Adherence to exercise seemed to be associated with lymphedema location, original diagnosis, perception of exercise benefits for daily activity performance and self-confidence, level of satisfaction with the exercise routine, recall of a prescribed exercise routine, and involvement in a variety of physical activities. Individuals with UE lymphedema, secondary to breast cancer, reported two of the highest three adherence percentages and all three of the highest percentages were associated with participation in a wider variety of physical activities. Amongst the eight participants, a higher adherence percentage was associated with the ability to recall the prescribed exercise routine, knowledge of exercise benefits for the lymphatic system, perceived effects of exercise on daily activities, increased self-confidence as a result of exercise, and the level of satisfaction with the routine. Further research should be implemented to compare the challenges of exercise between non-cancer versus cancer-related groups as well as to explore how occupational therapists working in this field can provide realistic and meaningful physical activity options for clients.

First Advisor

Martins Linauts

Date of Completion

Spring 2011

Degree Type







Degree Name

Master of Science in Occupational Therapy (MSOT)

Date of Award



Occupational Therapy


University of Puget Sound