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Strength Training Intervention for Breast Cancer Survivors and the Effects on Lymphedema Status

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00194363
Recruitment Status : Completed
First Posted : September 19, 2005
Last Update Posted : July 28, 2017
National Institutes of Health (NIH)
Information provided by (Responsible Party):
Kathryn Schmitz, Milton S. Hershey Medical Center

Brief Summary:

The purpose of the PAL trial is to increase the understanding of the experiences of long-term breast cancer survivors.

Study hypothesis: Strength training will not increase the rate of lymphedema or worsen lymphedema as compared to the non-exercising control participants.

Condition or disease Intervention/treatment Phase
Lymphedema Behavioral: Strength training Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 295 participants
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Other
Official Title: The PAL Trial (Physical Activity and Lymphedema)
Study Start Date : October 2005
Actual Primary Completion Date : July 2007
Actual Study Completion Date : July 2007

Resource links provided by the National Library of Medicine

Intervention Details:
  • Behavioral: Strength training
    13 weeks of supervised strength training (twice weekly for 90 minutes per session), 39 weeks of unsupervised strength training (twice weekly for 90 minutes per session)

Primary Outcome Measures :
  1. Specific aim 1: To determine whether there are any changes in lymphedema in breast cancer survivors who participate in a one-year randomized exercise intervention of twice-weekly strength training, as compared to a non-exercising group. [ Time Frame: 1 year ]

Secondary Outcome Measures :
  1. Secondary aim 1: To assess changes in physical functioning of the arms, as measured by tests of range of motion, coordination, pain, and strength that may result from strength training. [ Time Frame: 1 year ]
  2. Secondary aim 2: To assess changes in body composition that may occur from strength training. [ Time Frame: 1 year ]
  3. Secondary aim 3: To assess self-reported changes in health related quality of life, sleep, fatigue, self-esteem, optimism, life satisfaction, sexual function, body image, social support, and general quality of life. [ Time Frame: 1 year ]
  4. Secondary aim 4: To assess changes in psychosocial mediators of exercise behavior, as well as achievement of outcome expectancies that may occur from participation in strength training. [ Time Frame: 1 year ]
  5. Secondary aim 5: To assess changes in biomarkers related to breast cancer, among the participants who start the study with a BMI over 25. [ Time Frame: 1 year ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Women without lymphedema must be 1-5 years post breast cancer diagnosis
  • Women with lymphedema must be 1-15 years post breast cancer diagnosis
  • Women with lymphedema must have stable lymphedema. ONE of the following:

    • 0-40>10% girth volume difference between the affected and non- affected limb for a non-dominant arm
    • 6-40% girth volume difference between the affected and non- affected limb for a dominant arm inter-limb discrepancy in volume or circumference at the point of greatest visible difference OR swelling or obscuration of anatomic architecture upon close inspection OR pitting edema.

      • 2 cm circumference difference
    • A prior clinical diagnosis of lymphedema and having had any prior intensive lymphedema therapy on the affected arm

As well as ALL of the following four conditions:

  • Women with Lymphedema must have ALL of the following:

    • No recorded arm girth change of 15% or greater within the three months.
    • No more than one lymphedema related infection requiring antibiotics within the past 3 months.
    • Participation in all Activities of Daily Living (ADLs) without lymphedema exacerbation for the past 3 months.

Exclusion Criteria:

  • For ALL participants (with and without lymphedema)

    • No medical conditions or medications that would prohibit participation in an exercise program or would negatively impact our ability to test our primary aims
    • Not morbidly obese (body mass index >50 kg/m2)
    • No plans for additional (e.g. reconstructive) surgery during the study period
    • No bilateral breast cancers (because this prohibits our ability to assess the primary outcome of interest)
    • No strength training or other upper body resistive exercise within the past year
    • Not planning to move away from the area over the next year
    • Not pregnant or lactating or planning to become pregnant during the study
    • Among women who have given birth: at least 6 months post pregnancy and at least 3 months post lactation

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00194363

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United States, Pennsylvania
Penn State Cancer Institute
Philadelphia, Pennsylvania, United States, 17033
Sponsors and Collaborators
Milton S. Hershey Medical Center
National Institutes of Health (NIH)
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Principal Investigator: Kathryn Schmitz, PhD, MPH Milton S. Hershey Medical Center
Publications automatically indexed to this study by Identifier (NCT Number):

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Responsible Party: Kathryn Schmitz, Professor, Milton S. Hershey Medical Center Identifier: NCT00194363    
Other Study ID Numbers: R01CA106851-01 ( U.S. NIH Grant/Contract )
First Posted: September 19, 2005    Key Record Dates
Last Update Posted: July 28, 2017
Last Verified: July 2017
Keywords provided by Kathryn Schmitz, Milton S. Hershey Medical Center:
breast cancer
breast cancer survivors
strength training
breast cancer survivorship
Additional relevant MeSH terms:
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Lymphatic Diseases