High-intensity interval training and hyperoxia during chemotherapy: A case report about the feasibility, safety and physical functioning in a colorectal cancer patient

Abstract

Introduction: We conducted a case study to examine the feasibility and safety of high-intensity interval training (HIIT) with increased inspired oxygen content in a colon cancer patient undergoing chemotherapy. A secondary purpose was to investigate the effects of such training regimen on physical functioning.

Case presentation: A female patient (51 years; 49.1 kg; 1.65 m; tumor stage: pT3, pN2a (5/29), pM1a (HEP), L0, V0, R0) performed 8 sessions of HIIT (5 × 3 minutes at 90% of Wmax, separated by 2 minutes at 45% Wmax) with an increased inspired oxygen fraction of 30%. Patient safety, training adherence, cardiorespiratory fitness (peak oxygen uptake and maximal power output during an incremental cycle ergometer test), autonomous nervous function (i.e., heart rate variability during an orthostatic test) as well as questionnaire-assessed quality of life (EORTC QLQ-C30) were evaluated before and after the intervention.No adverse events were reported throughout the training intervention and a 3 months follow-up. While the patient attended all sessions, adherence to total training time was only 51% (102 of 200 minutes; mean training time per session 12:44 min:sec). VO2peak and Wmax increased by 13% (from 23.0 to 26.1 mL min kg) and 21% (from 83 to 100 W), respectively. Heart rate variability represented by the root mean squares of successive differences both in supine and upright positions were increased after the training by 143 and 100%, respectively. The EORTC QLQ-C30 score for physical functioning (7.5%) as well as the global health score (10.7%) improved, while social function decreased (17%).

Conclusions: Our results show that a already short period of HIIT with concomitant hyperoxia was safe and feasible for a patient undergoing chemotherapy for colon cancer. Furthermore, the low overall training adherence of only 51% and an overall low training time per session (∼13 minutes) was sufficient to induce clinically meaningful improvements in physical functioning. However, this case also underlines that intensity and/or length of the HIIT-bouts might need further adjustments to increase training compliance.

Conflict of interest statement

Competing interests: The authors declare that they have no competing interests.

The authors have no conflicts of interest to disclose.

Figures

Figure 1

Timing of basal measurements, exercise interventions and drug administrations; Chemotherapy was administered on 2 consecutive days every week; d days ∗NOTE a second baseline incremental test was performed to clarify cardiovascular uncertainties indicated during the first CPET (the patient completed the same workload during the second baseline assessment). CPET = cardiopulmonary exercise testing.

Figure 2

Self-reported weekly amounts of habitual physical activity, excluding prescribed HIIT sessions.

Figure 3

Heart rate (A) and blood lactate accumulation (B) during the cardiopulmonary exercise test before and after training; + indicates an increase from pre to post at the corresponding workload; - indicates a decrease from pre to post at the corresponding workload. ∗NOTE: the curves for pre are shorter due to a shorter time to exhaustion.

Figure 4

Patient-related outcomes on quality of life assessed by the EORTC QLQ-C30 functional scale (A) and perceived fatigue determined by the FACIT-F subscales (B) before and after the intervention in relation to the maximal values. NOTE: The FACIT-F questionnaire was assessed both before the first and last HIIT session. FACIT-F = functional assessment of chronic illness therapy-fatigue.