Table 3.

Lymphedema assessment, measurement details, and outcomes of the 6 newly included articles [41–46] published since September 2017 and details of previous studies published in Hasenoehrl et al. [11]

Author	Lymphedema assessment	Measurement details	Results
Ammitzbøll et al. [41]	Water displacement DXA	No measurement details Lymphedema was defined as a > 3% increase in ILVD. Measured outcome: ILMD Separate arm scans analyzed with Small Animal Program software (version 8.1027). In the subgroup of one study center (n = 77)	No significant mean change in ILVD No significant mean change in ILMD
Bloomquist et al. [42]	BIS DXA	Impedance of the extracellular fluid in the affected and nonaffected arms was assessed and compared (L-Dex score). Tissue composition and arm volume using a three-compartment model that is sensitive to changes in upper extremity tissue composition Using previously derived densities for fat (0.9 g mL−1), lean mass (1.1 g mL−1), and bone mineral content (1.85 g mL−1), DXA measurements were converted into estimated arm volumes.	Predetermined equivalence margin of ± 3.0 units: Equivalence between intensities was observed immediately after and 24 h after RE sessions. At 72 h post-RE session, equivalence could not be declared (lower CI exceeded − 3.0) favoring heavy load RE. Equivalence between intensities was observed at all time points for interlimb volume percent differences.
Bloomquist et al. [43]	DXA BIS	Equal to Bloomquist et al. [42] Equal to Bloomquist et al. [42] From participant 71 forward (n = 81)	Predetermined equivalence margin of ± 3.0 units: Nonequivalence was observed at all time points for interarm volume % differences favoring the HI-RE group. Equivalence between groups at 12 and 39 weeks. Equivalence to the predetermined equivalence margin at 12 weeks (per-protocol analysis) Nonequivalence to the predetermined equivalence margin at 39 weeks (upper CI exceeded 3.0) favoring the HI-RE group
Luz et al. [45]	Arm circumference	Measurement sites: • 14 and 7 cm above the olecranon • Circumference of the olecranon • 7, 14, and 21 cm below the olecranon • Circumference of the dorsum and palm, at the line of the metacarpals at the base of the fingers Further details: • Limb volume was calculated with the formula: V = h(C12 + C1C2 + C22)/(12π) [52] • V is the volume of the limb segment, C and c are the circumferences at each end, and h is the distance between the circumferences (C).	Between group change in arm volume not significant Within-group change showed decreased values in both RE groups (no level of significance reported).
Omar et al. [44]	Arm circumference	Measurement sites: • Circumference was taken at the levels of metacarpal and wrist, and at 4-cm intervals up the arm until the base of the axilla for both affected and unaffected limbs Further details: • Limb volume was calculated with the formula: V = h(C12 + C1C2 + C22)/(12π) [52]	At the end of treatment (week 8), the ELV and %ELV decreased significantly in both groups. These reductions were sustained to follow-up (week 12). No significant changes in the relative volume (% reduction ELV) were observed between groups at the end of treatment (week 8) or at follow-up (week 12).
Schmitz et al. [46]	Arm volume (perometry)	Outcome measure: percentage of interlimb volume differences	No between-group differences were noted at baseline or in 12-month changes in percentage or absolute interlimb differences. Individual limb decreases across 12 months were larger for both affected and unaffected limbs in the weight loss and combined intervention groups compared with the control group.

BIS bioimpedance spectroscopy, CI confidence interval, DXA dual X-ray absorptiometry, ELV excess limb volume, HI high intensity, ILMD interlimb mass difference, ILVD interlimb volume difference, RE resistance exercise