The participants were women who had attended a “reducing
your risk of lymphoedema” class, taught by the author
(EJ) at a London breast cancer support charity between
2000 and 2005 (Jeffs 2006). The 1½ h class consisted of two
parts: (1) explanation of BCRL, risk, and measures that may
reduce risk of developing BCRL; (2) demonstration and
practice of a simple 10–15 min exercise routine for daily
home use. The exercise routine consisted of a proximal to
distal sequence of deep breathing and gravity-resistive isotonic
arm exercises (flexibility and strengthening) designed
to stimulate lymphatic and venous return. The class encouraged
a return to pre-treatment exercise and activities at a
time when women receiving breast cancer treatment in the
UK were routinely advised not to lift more than 3 lb weight.