# Highly favorable physiological responses to concurrent resistance and high-intensity interval training during chemotherapy: the OptiTrain breast cancer trial

PMID: 29349712
Journal: Breast Cancer Research and Treatment
Published: 2018 May
Authors: Mijwel S, Backman M, Bolam KA, Olofsson E, Norrbom J, Bergh J, Sundberg CJ, Wengström Y, Rundqvist H

## 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.

## Population

- Women aged 18-70 with stage I-IIIa breast cancer receiving anthracycline- and/or taxane-based chemotherapy.
- Sample size: 240
- Age: 18-70 years eligible; group means about 52.6-54.4 years.
- Sex: Women
- Fitness level: Mixed baseline activity; baseline sedentary time about 63.7%-66.6% of daily wear time.
- Health status: Breast cancer stage I-IIIa during chemotherapy; cardiac pathologies, major psychiatric disorders, and other malignant diseases excluded.

## Methodology

- In-clinic, three-arm randomized controlled trial with outcomes measured at baseline and 16 weeks; this report analyzes physiological outcomes from the OptiTrain trial.
- 16 weeks
- Karolinska University Hospital rehabilitation center, Stockholm, Sweden
- Randomized and controlled study design.

## Protocol

- RT-HIIT and AT-HIIT.
- Modality: Concurrent resistance plus HIIT or moderate-intensity aerobic plus HIIT.
- Work intervals: 3 minutes.
- Recovery: About 1 minute.
- Sets or repetitions: 3 HIIT bouts; RT-HIIT also used 2-3 sets of 8-12 resistance repetitions.
- Intensity: HIIT RPE 16-18; AT aerobic RPE 13-15; RT 80% estimated 1RM.
- Frequency: Twice weekly.
- Program length: 16 weeks.
- Progression: Resistance loads adjusted when participants exceeded 12 repetitions; program extended for chemotherapy delays.
- Usual care.
- Modality: Usual care without supervised exercise intervention described in this article.
- Program length: 16 weeks.

## Outcomes

### Predicted VO2peak
Status: improved
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
Status: improved
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
Status: improved
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
Status: improved
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
Status: no clear change
Hemoglobin decreased similarly in all groups.

## Practical 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 And Adherence

- 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.

## Original Sources

- [PubMed](https://pubmed.ncbi.nlm.nih.gov/29349712/) (pubmed)
- [DOI](https://doi.org/10.1007/s10549-018-4663-8) (doi)
- [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5882634/) (full text)

## Agent Guidance

Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.