Adding high-intensity interval training to conventional training modalities: optimizing health-related outcomes during chemotherapy for breast cancer: the OptiTrain randomized controlled trial

Sara Mijwel, Malin Backman, Kate A Bolam, Anna Jervaeus, Carl Johan Sundberg, Sara Margolin, Maria Browall, Helene Rundqvist, Yvonne Wengström, Sara Mijwel, Malin Backman, Kate A Bolam, Anna Jervaeus, Carl Johan Sundberg, Sara Margolin, Maria Browall, Helene Rundqvist, Yvonne Wengström

Abstract

Purpose: Exercise 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.

Methods: Two 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.

Results: The 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).

Conclusions: 16 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 registration: Clinicaltrials.gov Registration Number: NCT02522260.

Keywords: Breast cancer; Chemotherapy; Concurrent training; Health-related quality of life; High-intensity interval training; Symptom burden.

Conflict of interest statement

Availability of data and material

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Figures

Fig. 1
Fig. 1
CONSORT diagram. RT–HIIT resistance and high-intensity interval training, AT–HIIT moderate-intensity aerobic and high-intensity interval training, UC usual care
Fig. 2
Fig. 2
Baseline status and change after 16 weeks for the outcomes. a CRF (assessed by the Piper fatigue scale), b global HRQoL (assessed by the European Organization for Research and Treatment of cancer quality of life questionnaire), c symptom burden (assessed by the Memorial symptom assessment scale), and d total symptom score (assessed by the Memorial symptom assessment scale). CRF cancer-related fatigue, HRQoL health-related quality of life, CRF cancer-related fatigue, HRQoL health-related quality of life, RT–HIIT resistance and high-intensity interval training, AT–HIIT moderate-intensity aerobic and high-intensity interval training, UC usual care
Fig. 3
Fig. 3
Activity levels at baseline based on the subgroups. a CRF and no CRF at baseline (assessed by the Piper fatigue scale), b low global HRQoL and high global HRQoL at baseline (assessed by the European Organization for Research and Treatment of cancer quality of life questionnaire), c high symptom burden and low symptom burden at baseline (assessed by the Memorial symptom assessment scale), and d high total symptom score and low total symptom score at baseline (assessed by the Memorial symptom assessment scale). CRF cancer-related fatigue, HRQoL health-related quality of life. *p < 0.05 between subgroups

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