Highly favorable physiological responses to concurrent resistance and high-intensity interval training during chemotherapy: the OptiTrain breast cancer trial
Question
The study examined whether concurrent resistance and high-intensity interval training or concurrent moderate-intensity aerobic and high-intensity interval training during chemotherapy improved physiological outcomes and pressure-pain threshold compared with usual care in women with breast cancer.
Summary
In women with stage I-IIIa breast cancer receiving chemotherapy, 16 weeks of twice-weekly supervised exercise that included high-intensity intervals helped prevent the usual-care decline in predicted cardiorespiratory fitness and helped limit body-mass gain. The resistance-plus-HIIT program also improved handgrip and lower-limb strength and produced higher pressure-pain thresholds than usual care and, for some measures, than aerobic-plus-HIIT.
Methodology
- Women aged 18-70 with stage I-IIIa breast cancer receiving anthracycline- and/or taxane-based chemotherapy.
- 240 participants.
- Concurrent resistance plus HIIT or moderate-intensity aerobic plus HIIT.
- Work intervals: 3 minutes.
- Recovery: About 1 minute.
- Intensity: HIIT RPE 16-18; AT aerobic RPE 13-15; RT 80% estimated 1RM.
- Twice weekly.
- 16 weeks.
- In-clinic, three-arm randomized controlled trial with outcomes measured at baseline and 16 weeks; this report analyzes physiological outcomes from the OptiTrain trial.
- Predicted VO2peak, Handgrip strength, Lower-limb muscle strength, and Body mass were tracked.
Outcomes
Predicted VO2peak
RT-HIIT and AT-HIIT maintained predicted VO2peak while usual care declined.
RT-HIIT vs usual care ES=0.41; AT-HIIT vs usual care ES=0.42.
Muscle strength
RT-HIIT improved handgrip and lower-limb strength and was superior to usual care and AT-HIIT for several strength comparisons.
Handgrip surgery side RT-HIIT vs UC ES=0.41 and vs AT-HIIT ES=0.28; non-surgery side RT-HIIT vs UC ES=0.35 and vs AT-HIIT ES=0.22; lower-limb strength RT-HIIT vs UC ES=0.66 and vs AT-HIIT ES=0.23; AT-HIIT vs UC ES=0.48.
Body mass
Usual care gained body mass, while both exercise groups maintained body mass relative to usual care.
RT-HIIT vs UC ES=-0.16; AT-HIIT vs UC ES=-0.16.
Pressure-pain threshold
RT-HIIT reported higher pressure-pain thresholds than usual care at trapezius and gluteus and higher trapezius pressure-pain threshold than AT-HIIT.
RT-HIIT vs UC: trapezius ES=0.46, gluteus ES=0.53; RT-HIIT vs AT-HIIT: trapezius ES=0.30.
Hemoglobin
Hemoglobin decreased similarly in all groups.
Insights
- In medically screened breast cancer patients during chemotherapy, supervised twice-weekly HIIT-containing exercise can be tolerated and may preserve cardiorespiratory fitness.
- Resistance training plus HIIT appears more useful than aerobic plus HIIT when strength and pressure-pain threshold are target outcomes.
- Clinical HIIT programming should preserve supervision and screening assumptions when translated for special populations.
Limitations
- The study population was a specific clinical group: women with stage I-IIIa breast cancer receiving chemotherapy.
- Participants, exercise supervisors, and outcome assessors were not masked.
- Predicted VO2peak was estimated from a submaximal test.
- The article reports adherence and detailed protocol information as previously published elsewhere rather than fully in this text.
- Combined interventions prevent isolating HIIT as the sole active component.
Safety
- No adverse events prompting medical attention occurred during exercise sessions.
- Sessions were supervised by an exercise physiologist or oncology nurse.
- Cardiac pathologies were exclusionary and assessed by ECG and questionnaire.