Concurrent Aerobic and Resistance Training Prevents Physical Fatigue in Patients with Breast Cancer during Chemotherapy

Abstract

PURPOSE: After a cancer diagnosis, one of the most commonly reported symptoms is cancer related fatigue (CRF). The use of physical exercise to improve cardiorespiratory fitness, body composition, and symptoms for patients with cancer during therapy is an emerging area of research. This in-clinic trial compared the effects of high intensity concurrent aerobic and resistance training (CART) and aerobic training (AT) to usual care (UC) on multiple parameters of physical function in patients with breast cancer during chemotherapy. METHODS: Women with breast cancer stage I-IIIa receiving chemotherapy were randomly allocated to 16 weeks of CART (2-3 sets of 8-12 repetitions at 70-80 % of estimated 1 repetition maximum strength, followed by 3x3 min bouts of high intensity intermittent aerobic exercise), AT (20 min moderate intensity continuous aerobic exercise, followed by 3x3 min bouts of high intensity intermittent aerobic exercise), or UC (control group). Physical CRF, cardiorespiratory fitness, muscle strength, and BMI were measured at baseline and after 16 weeks. Clinically important changes were estimated as standardized effect sizes. RESULTS: A significant difference in fatigue was found between CART and UC post-intervention (p=0.015, ES=-0.48), with CART maintaining baseline levels and UC demonstrating a significant deterioration of CRF. Significant differences in estimated VO2peak were found favoring CART (p<0.001, ES=0.44) and AT (p<0.001, ES=0.57) compared to UC. Women in the CART group demonstrated significant differences in muscle strength superior to both AT and UC for right handgrip- (CART vs. AT: p=0.009, ES=0.29; CART vs. UC: p<0.001, ES=0.41) and lower limb muscle strength (CART vs. AT: p=0.007, ES=0.24; CART vs. UC: p<0.001, ES=0.65). Increases in BMI were significantly smaller in both CART (p=0.013, ES=-0.14) and AT (p=0.005, ES=-0.14) compared to UC. CONCLUSIONS: A 16-week high intensity CART intervention appears to be more effective than AT alone in counteracting physical CRF and improving muscle strength, and was equally as efficient as AT in maintaining cardiorespiratory fitness. Concurrent high intensity aerobic and resistance training is an effective and feasible training intervention, and can be prescribed to patients with breast cancer during chemotherapy.