{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T04:56:25Z","timestamp":1794027385600,"version":"4.8.0"},"reference-count":46,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lymphatic Research and Biology"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Lower-limb lymphedema (LLL) secondary to gynecological cancer is a serious health condition that negatively affects physical activity (PA). We investigated the association between objectively measured PA and lymphedema markers in patients with LLL after gynecological cancer treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results:<\/jats:title>\n                    <jats:p>\n                      This cross-sectional study included 56 patients (mean age: 62.0 years) with LLL attending a lymphedema center. The degree of lymphedema was evaluated based on lower-limb water content (extracellular water content\/whole body water content: ECW\/TBW). The amount and intensity of PA were measured using an accelerometer. Thirty-three patients (61.1%) with ECW\/TBW \u22650.4 were older, had significantly more sedentary time, and spent lesser time on moderate-to-vigorous activity than patients with ECW\/TBW &lt;0.4 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.05). A generalized linear model using the rate of change in ECW\/TBW showed an association with older age, longer time since cancer diagnosis, and lower activity level. The severity of subjective symptoms measured using a visual analog scale did not differ between patients with high and low ECW\/TBW.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Patients with LLL spent approximately half of the time in sedentary behavior, with more severe cases exhibiting longer sedentary durations. In older patients who have a long-standing cancer diagnosis, medical professionals should evaluate their activity and self-care status in addition to evaluating LLL and use this information to provide individualized interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15578585251376172","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T15:13:03Z","timestamp":1757603583000},"page":"298-305","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Association Between Objectively Measured Physical Activity and Lower-Limb Lymphedema Markers in Patients with Lymphedema Secondary to Gynecological Cancer: A Cross-Sectional Study"],"prefix":"10.1177","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2969-1859","authenticated-orcid":false,"given":"Yuriko","family":"Matsunaga-Myoji","sequence":"first","affiliation":[{"name":"Division of Nursing, Saga University, Saga, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimie","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Health Science, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satomi","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Health Science, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miyuki","family":"Izumi","sequence":"additional","affiliation":[{"name":"Division of Nursing, Kyushu University Hospital, Fukuoka, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urara","family":"Hirata","sequence":"additional","affiliation":[{"name":"Division of Nursing, Kyushu University Hospital, Fukuoka, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoko","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2019.10.009"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-010-0171-5"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000372"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-013-1879-3"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2020.10.023"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2017.02.021"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djs530"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13337"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2017.06.004"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31239"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-017-0403-1"},{"key":"e_1_3_6_13_2","unstructured":"NCCN Guidelines for patients. 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