Exercise and physiotherapy for enhancing muscle strength, managing lower-limb lymphedema, and improving sexual function in the treatment and survivorship of gynecological cancers

Gynecological neoplasms, encompassing ovarian, cervical, and endometrial cancers, frequently lead to considerable physical and functional disabilities as a result of surgical intervention, radiotherapy, and pharmacological treatments such as chemotherapy. Prominent among the most prevalent sequelae are muscular weakness, lymphedema of the lower extremities, and sexual dysfunction, which together undermine quality of life and long-term survivorship. Recent scholarly evidence underscores the significance of exercise and physiotherapeutic interventions in alleviating these detrimental consequences. Resistance training and multimodal exercise regimens have demonstrated efficacy in augmenting muscular strength, thereby enhancing functional autonomy and overall physical capability in survivors of gynecological malignancies. Interventions grounded in physiotherapy, which encompass lymphatic drainage techniques and specialized rehabilitation programs, are effective in the management of lower-limb lymphedema, leading to a reduction in swelling, discomfort, and the potential for secondary complications. Moreover, rehabilitation of the pelvic floor and regimented physical activity can exert a beneficial effect on sexual function, particularly in relation to arousal, orgasmic dysfunctions, and concomitant discomfort. Preclinical investigations further substantiate the mechanistic framework underlying these interventions, revealing advancements in muscle morphology, lymphatic flow, and neuromuscular capabilities. Notwithstanding these encouraging results, the variability in intervention methodologies and outcome assessment presents a significant constraint. This review amalgamates the existing clinical and preclinical literature regarding exercise and physiotherapeutic approaches, underscoring their combined efficacy in augmenting muscular strength, managing lymphedema, and enhancing sexual health within the context of gynecologic oncology. Such revelations may pave the way for future research endeavors and facilitate the formulation of individualized, multimodal rehabilitation strategies aimed at optimizing survivorship outcomes.