Reaching consensus on exercise recommendations for individuals living with lower limb lymphoedema: a Delphi study

Area of Science:

• Exercise Science
• Clinical Rehabilitation
• Lymphedema Management

Background:

• Current exercise guidelines for lymphoedema predominantly address upper limb conditions.
• There is a lack of specific, evidence-based recommendations for exercise in lower limb lymphoedema.
• Distinct physiological differences between upper and lower limbs necessitate tailored exercise approaches.

Purpose of the Study:

• To develop a comprehensive framework of exercise recommendations for individuals with lower limb lymphoedema.
• To provide clarity on effective exercise types, frequency, and intensity for lower limb lymphoedema.
• To guide healthcare professionals in prescribing exercise for lower limb lymphoedema.

Main Methods:

• A modified two-round e-Delphi methodology was employed.
• An expert panel of 54 international participants reviewed and rated 68 exercise recommendations and 3 compression garment recommendations.
• A literature review informed the initial draft framework.

Main Results:

• A final framework comprising 26 exercise recommendations was established.
• Recommendations were categorized into resistance (7), aerobic (15), and flexibility (4) domains.
• Three recommendations specifically addressed the use of compression garments during exercise.

Conclusions:

• The developed framework provides structured guidance for healthcare professionals.
• It facilitates the prescription of multimodal exercise programs for lower limb lymphoedema.
• This framework aims to improve patient outcomes and management of lower limb lymphoedema.