Malicka 2011.

Methods	Study design: single‐centre RCT Number randomised: 38; 23 to a Nordic walking intervention, 15 to control Study start: not reported; stop date: not reported Length of intervention: 8 weeks Length of follow‐up: to end of intervention Country: Poland
Participants	Age, years, mean: Overall: 62.8 Stage, n (%): Intervention: not reported Control: not reported Inclusion criteria: • Women after treatment for breast cancer Exclusion criteria: • None reported
Interventions	23 participants assigned to exercise intervention: Warm‐up (10‐minute): exercise of upper extremities with the use of poles, not only to prepare the body for the subsequent effort but also as part of lymphoedema prophylaxis Nordic walking (40‐minute) aimed at learning and improving walking technique with the use of special poles (load applied was 85% of HRmax (220–age), with pulse monitored by Polar testers throughout the activity Concluding part (10‐minute) involving application of muscle stretching, respiratory, and relaxation exercises, taking into account lymphoedema prophylaxis Adherence: Not reported 15 participants assigned to control: Control group comprised 15 women not participating in any rehabilitation programme (no physical activity for the same duration).
Outcomes	Outcomes: Biodex Multi‐Joint 3 isokinetic dynamometer used to assess muscle strength bilaterally with the upper limb push‐pull attachment of the Biodex (pushing motion consisting of shoulder flexion and elbow extension, and pulling motion consisting of shoulder extension and elbow flexion) Upper extremities circumference (volume of lymphoedema) Time points of assessment: baseline, at 8 weeks Numbers of participants assessed: Intervention: baseline, 23; at 8 weeks, 23 Control: baseline, 15; at 8 weeks, 15 Adverse events: not reported
Notes	Trial registration link: none available Trial authors contacted: no Intention‐to‐treat analysis: yes, no missing data were reported Funding: none reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	"The participants were randomly assigned to one of two groups". No method stated
Allocation concealment (selection bias)	Unclear risk	Whether treatment assignment was concealed from study personnel and participants was not described.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Owing to the nature of the intervention, it was not possible to conceal allocation to the intervention from participants.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Blinding of outcome assessments was not described.
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing data (no dropouts) are apparent.
Selective reporting (reporting bias)	Low risk	No selective reporting of outcomes is apparent.
Other bias	Low risk	Trial appears to be free of other problems that could put it at high risk of bias.