# Effects of high-intensity interval training on fatigue and quality of life in testicular cancer survivors PMID: 29736007 Journal: British Journal of Cancer Published: 2018-05-08 Authors: Adams SC, DeLorey DS, Davenport MH, Fairey AS, North S, Courneya KS ## Question Does 12 weeks of supervised high-intensity interval training improve patient-reported outcomes in testicular cancer survivors compared with usual care, and are effects mediated by cardiorespiratory fitness or moderated by baseline clinical characteristics? ## Summary In a phase II randomized controlled trial, 63 testicular cancer survivors were assigned to 12 weeks of supervised treadmill high-intensity interval training or usual care. The HIIT group improved cancer-related fatigue, self-esteem, and several health-related quality-of-life domains after training, with fatigue and vitality benefits persisting at 3-month follow-up. Training adherence and target-intensity achievement were very high, and no exercise-related serious adverse events were reported. ## Population - Post-treatment male testicular cancer survivors with confirmed stage I-IV history, excluding regular vigorous exercisers and those with uncontrolled cardiovascular or psychiatric conditions. - Sample size: 63 - Age: Mean 43.7 years; range 21-61 years - Sex: Male - Fitness level: Mean VO2peak 37.0 ml O2/kg/min; 55.6% below 35th percentile. - Health status: Testicular cancer survivors, median about 7 years postdiagnosis in abstract and mean 8.0 years since diagnosis in table. ## Methodology - Prospective two-arm phase II randomized controlled trial with post-intervention and 3-month follow-up assessments. - 12-week intervention plus 3-month follow-up - Supervised exercise training facility and usual-care follow-up in Edmonton, Alberta, Canada. - Randomized and controlled study design. ## Protocol - Supervised treadmill HIIT. - Modality: Uphill treadmill walking or running. - Work intervals: 4 min. - Recovery: 3 min active recovery. - Sets or repetitions: 4 intervals. - Intensity: 75%-95% VO2peak for work intervals; recovery 5%-10% below ventilatory threshold. - Session duration: 35 min. - Frequency: 3 sessions/week. - Program length: 12 weeks. - Progression: Gradual increase from 75% to 95% VO2peak over the intervention. - Usual care. - Modality: Maintain baseline exercise levels. - Program length: 12 weeks plus 3-month follow-up before offered HIIT. ## Outcomes ### Cancer-related fatigue Status: improved HIIT significantly improved post-intervention fatigue compared with usual care, and the effect persisted at 3-month follow-up. Post-intervention adjusted between-group mean difference 4.4 points, 95% CI 1.5 to 7.3, p=0.003; follow-up p=0.031. ### Self-esteem Status: improved HIIT significantly improved self-esteem at post-intervention compared with usual care. p=0.029 ### SF-36 HRQoL domains Status: improved HIIT improved mental component score, vitality, social functioning, general health, and role-physical at post-intervention; vitality persisted at follow-up. MCS p=0.034, vitality p=0.001, social functioning p=0.011, general health p=0.016, role-physical p=0.048; 3-month vitality p=0.015. ### Depression, anxiety, stress, sleep quality, and selected SF-36 domains Status: no clear change No significant effects were observed for depression, anxiety, stress, sleep quality, physical functioning, bodily pain, role-emotional, or physical component score. Depression p=0.81, anxiety p=0.19, stress p=0.22, sleep quality p=0.15, physical functioning p=0.77, bodily pain p=0.41, role-emotional p=0.36, PCS p=0.34. ### Cardiorespiratory fitness Status: improved HIIT improved VO2peak relative to usual care, and VO2peak changes mediated selected PRO improvements. VO2peak improved by 3.7 ml O2/kg/min, p<0.001; mediation evidence reported for MCS, mental health, CRF, and vitality at p<0.05 or p<0.10 depending on outcome/timepoint. ## Practical Insights - A supervised 4 x 4-minute HIIT protocol can be feasible and highly adherent in selected testicular cancer survivors. - Fatigue and vitality are stronger practical targets from this study than depression, anxiety, stress, or sleep quality. - Clinical HIIT programming should include screening, supervision, and progression rather than direct unsupervised transfer. ## Limitations - No outcome assessor blinding. - Low initial response rate and possible self-selection bias. - Limited 3-month follow-up. - Variable time since diagnosis. - Small sample size for PRO analyses. - Loss to follow-up at 3 months. - Baseline clinical fatigue imbalance. - No attention-control comparison group. - Exploratory mediation and moderation analyses. ## Safety And Adherence - No exercise-related serious adverse events were reported or observed. - Participants achieved 98% of target work-phase heart rates and attended 99% of sessions under one-on-one supervision. ## Original Sources - [PubMed](https://pubmed.ncbi.nlm.nih.gov/29736007/) (pubmed) - [DOI](https://doi.org/10.1038/s41416-018-0044-7) (doi) - [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5959855/) (full text) ## Agent Guidance Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.