CLT CLT Exercise & Movement Therapy 3 — Questions and Answers
Question 1: Based on current evidence, what is the effect of slowly progressive resistance training on lymphedema in breast cancer survivors?
- It does not worsen and may reduce lymphedema symptoms while improving strength and quality of life (Correct answer)
- It consistently worsens lymphedema and should never be prescribed
- It has no measurable effect on lymphedema outcomes
- It is only safe for Stage I lymphedema, not Stage II or III
Correct answer: It does not worsen and may reduce lymphedema symptoms while improving strength and quality of life
Evidence from multiple randomized controlled trials shows slowly progressive resistance training is safe and may decrease the number of lymphedema exacerbations while improving upper extremity strength.
Question 2: Which breathing technique is specifically used during MLD and remedial exercises to maximize lymphatic drainage?
- Diaphragmatic breathing (abdominal breathing) with slow, deep inhalation and full exhalation (Correct answer)
- Pursed-lip breathing to prolong exhalation
- Rapid shallow chest breathing to increase respiratory rate
- Breath-holding at peak inhalation for 10 seconds
Correct answer: Diaphragmatic breathing (abdominal breathing) with slow, deep inhalation and full exhalation
Deep diaphragmatic breathing maximizes intrathoracic pressure changes, creating the strongest suction effect on the thoracic duct and cisterna chyli to draw lymph proximally.
Question 3: What post-exercise recommendation helps maintain the reduction gained during a CDT exercise session?
- Continue wearing compression garment and elevate the limb if swelling increases after exercise (Correct answer)
- Remove the compression garment immediately after exercise to let skin breathe
- Apply heat to the limb post-exercise to maintain vessel dilation
- Rest completely for 4 hours without any limb movement
Correct answer: Continue wearing compression garment and elevate the limb if swelling increases after exercise
Maintaining compression post-exercise prevents the reaccumulation of fluid mobilized during exercise, and elevation uses gravity to assist lymphatic drainage back toward the trunk.
Question 4: How does yoga or tai chi benefit patients with lymphedema?
- Rhythmic movement, diaphragmatic breathing, and postural awareness combine to enhance lymphatic flow without high-intensity load (Correct answer)
- Yoga's inverted poses reverse lymphatic flow to clear congested nodes
- Tai chi's rapid movements create a strong muscle pump equivalent to running
- These activities are contraindicated in lymphedema due to unpredictable limb positions
Correct answer: Rhythmic movement, diaphragmatic breathing, and postural awareness combine to enhance lymphatic flow without high-intensity load
Yoga and tai chi combine slow rhythmic movement, conscious deep breathing, and postural correction, all of which facilitate gentle lymph propulsion without generating excessive filtration.
Question 5: What is the primary concern with high-intensity exercise in lymphedema patients?
- Rapid increase in capillary filtration overwhelms the already-reduced lymphatic transport capacity, risking a flare (Correct answer)
- High intensity permanently damages lymphatic vessel walls
- It causes excessive weight loss that destabilizes compression garment fit
- High heart rate prevents lymph from entering the venous system at the thoracic duct
Correct answer: Rapid increase in capillary filtration overwhelms the already-reduced lymphatic transport capacity, risking a flare
High-intensity exercise dramatically increases capillary filtration from elevated blood flow and pressure, producing more interstitial fluid than a compromised lymphatic system can clear, potentially triggering acute swelling.
Question 6: What role does posture correction play in upper extremity lymphedema management?
- Proper posture prevents compression of axillary and cervical lymphatic pathways that impair proximal lymph drainage (Correct answer)
- Posture has no measurable impact on lymphatic flow in the upper extremity
- Upright posture increases hydrostatic pressure in arm veins, worsening lymphedema
- Slouching is preferred as it shortens the distance lymph must travel to reach the thoracic duct
Correct answer: Proper posture prevents compression of axillary and cervical lymphatic pathways that impair proximal lymph drainage
Forward head posture and rounded shoulders can compress the axillary region and thoracic outlet, restricting lymphatic pathways and impairing drainage from the upper extremity into the central lymphatic system.
CLT CLT Exercise & Movement Therapy 3
Based on current evidence, what is the effect of slowly progressive resistance training on lymphedema in breast cancer survivors?