Abstract: Objective: To introduce the design and effectiveness of the preventive exercise prescription of arm lymphedema in breast cancer survivors. Methods: According to the new theory of muscle-lymphatic-drainage pump, we advocate active and moderate arm exercises from the perspective of post-operative breast cancer survivors. Using the depth interview and participatory observation in qualitative research, developing the arm exercises and protective measures rooted in breast cancer survivors' self-care experiences and strategies in their daily lives, which enriched the preventive exercise rehabilitation intervention measures and experience of lymphedema. Following the exercise prescription principle (FITT-VP), a 12 week of preventive exercise prescription for breast cancer survivors to prevent arm lymphedema was developed under the guidance of the American exercise rehabilitation coach, including the strength training, aerobic exercise and flexibility exercise. A total of 106 breast cancer survivors were recruited, the control group consisted of 50 patients who received routine education, and the intervention group consisted of 56 patients who received exercise prescription, including 13 arm lymphedema patients. The arm lymphedema outcome, muscle strength and cardiopulmonary endurance were used to evaluate the effect of exercise prescription. Results: The breast cancer survivors in the intervention group not only didn't develop arm lymphedema, but their arm muscle strength and cardiopulmonary endurance were improved pre to post intervention. Moreover, the edema symptoms of the arm lymphedema patients subsided somewhat. Conclusion: The preventive exercise prescription of arm lymphedema can improve the muscle strength and the cardiopulmonary endurance of breast cancer survivors, and reduce the risk of arm lymphedema, and improve the symptoms in patients with arm lymphedema.

Key words: breast cancer; lymphedema; exercise prescription; rehabilitation nursing