Abstract
PurposeExercise training is an effective and safe way to counteract cancer-related fatigue (CRF) and to improve health-related quality of life (HRQoL). High-intensity interval training has proven beneficial for the health of clinical populations. The aim of this randomized controlled trial was to compare the effects of resistance and high-intensity interval training (RT–HIIT), and moderate-intensity aerobic and high-intensity interval training (AT–HIIT) to usual care (UC) in women with breast cancer undergoing chemotherapy. The primary endpoint was CRF and the secondary endpoints were HRQoL and cancer treatment-related symptoms.MethodsTwo hundred and forty women planned to undergo chemotherapy were randomized to supervised RT–HIIT, AT–HIIT, or UC. Measurements were performed at baseline and at 16 weeks. Questionnaires included Piper Fatigue Scale, EORTC-QLQ-C30, and Memorial Symptom Assessment Scale.ResultsThe RT–HIIT group was superior to UC for CRF: total CRF (p = 0.02), behavior/daily life (p = 0.01), and sensory/physical (p = 0.03) CRF. Role functioning significantly improved while cognitive functioning was unchanged for RT–HIIT compared to declines shown in the UC group (p = 0.04). AT–HIIT significantly improved emotional functioning versus UC (p = 0.01) and was superior to UC for pain symptoms (p = 0.03). RT–HIIT reported a reduced symptom burden, while AT–HIIT remained stable compared to deteriorations shown by UC (p < 0.01). Only RT–HIIT was superior to UC for total symptoms (p < 0.01).Conclusions16 weeks of resistance and HIIT was effective in preventing increases in CRF and in reducing symptom burden for patients during chemotherapy for breast cancer. These findings add to a growing body of evidence supporting the inclusion of structured exercise prescriptions, including HIIT, as a vital component of cancer rehabilitation.Trial registrationClinicaltrials.gov Registration Number: NCT02522260.
Highlights
Adjuvant chemotherapy improves survival and decreases the risk of recurrence of breast cancer [1]
The aim of this study was to compare the effects of two training interventions: 1) resistance and high-intensity interval training (RT–HIIT), and 2) moderate-intensity aerobic and high-intensity interval training (AT–HIIT), to a control group receiving usual care (UC) on cancer-related fatigue (CRF), healthrelated quality of life (HRQoL), and symptoms in women with breast cancer undergoing chemotherapy
A significant difference was found for symptom burden as measured by the Memorial Symptom Assessment Scale (MSAS), with RT–HIIT (ES = − 0.43) reporting a reduced symptom burden score and AT–HIIT (ES = − 0.42) was unchanged compared to an increased score for UC
Summary
Adjuvant chemotherapy improves survival and decreases the risk of recurrence of breast cancer [1]. The evidence shows improvements in cardiorespiratory fitness compared to moderate-intensity aerobic training, and added benefits on quality of life [14], mood state [15, 16], and cognitive health [17] and increases endorphin release in brain areas associated with controlling emotion and pain [18]. We hypothesize that combining HIIT with conventional exercise provide added benefits on CRF, HRQoL, and symptom burden This is the first large RCT to incorporate this emerging training modality in patients with breast cancer during chemotherapy. The aim of this study was to compare the effects of two training interventions: 1) resistance and high-intensity interval training (RT–HIIT), and 2) moderate-intensity aerobic and high-intensity interval training (AT–HIIT), to a control group receiving usual care (UC) on CRF, HRQoL, and symptoms in women with breast cancer undergoing chemotherapy
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