# The Effect of High-Intensity Interval Training on Quality of Life and Incidence of Chemotherapy Side Effects in Women With Breast Cancer PMID: 39548802 Journal: Integrative Cancer Therapies Published: 2024 Jan-Dec Authors: Klavina A, Ceseiko R, Campa M, Jermolenko GF, Eglitis K, Llorente A, Linē A ## Question Does a 6-month individualized high-intensity aerobic interval walking program improve quality of life and reduce the incidence of neoadjuvant chemotherapy side effects in women with locally advanced breast cancer? ## Summary Women with stage II-III breast cancer undergoing neoadjuvant chemotherapy were randomized to a 6-month free-living walking HIIT program or standard care. Among the 37 participants included in per-protocol analyses, the HIIT group had better symptom-related quality-of-life outcomes and lower incidence of some chemotherapy-related physical, social, and fatigue side effects, while psychological complaints were more frequent in the HIIT group. No adverse events were reported during assessments or intervention sessions, but dropout was high and analysis excluded many randomized participants. ## Population - Women with newly diagnosed locally advanced stage II-III breast cancer undergoing neoadjuvant chemotherapy. - Sample size: 56 - Age: Mean 48.56 years, SD 7.84; abstract reports range 35-64 years and methods inclusion age 36-65 years. - Sex: Women only. - Health status: Stage II-III breast cancer during neoadjuvant chemotherapy; analyzed sample HIIT n=17 and control n=20. ## Methodology - Randomized controlled trial with a 6-month free-living HIIT intervention and standard-care control; this publication used per-protocol analysis for quality-of-life and side-effect outcomes. - 6 months during neoadjuvant chemotherapy. - Breast Cancer Clinic, Riga East University Hospital recruitment with free-living walking training at participant-chosen locations and remote Polar Flow reporting. - Randomized and controlled study design. ## Protocol - HIIT walking program. - Modality: Walking HIIT on treadmill or participant-selected walking routes. - Work intervals: 4 x 4 minutes at 85%-95% HRmax, RPE 7-8 on Modified Borg scale. - Recovery: 3 minutes active recovery at 55%-70% HRmax between work intervals. - Sets or repetitions: Four high-intensity walking intervals per session. - Intensity: Prescribed by individualized HRmax zones and Modified Borg RPE. - Session duration: 34 minutes. - Frequency: 2 to 3 sessions per week. - Program length: 6 months during neoadjuvant chemotherapy. - Progression: Participants received initial supervised setup and sent Polar Flow outputs after each session; detailed progression rules were not reported. - Standard care control. - Modality: No structured exercise intervention reported. - Program length: 6 months concurrent with neoadjuvant chemotherapy. ## Outcomes ### Quality-of-life symptom scores Status: improved HIIT had significantly better post-intervention symptom outcomes than control for EORTC QLQ-C30 symptom scale, systemic therapy side effects, and QLQ-BR23 symptom scale. EORTC QLQ-C30 symptom scale P=.048, ES=0.113; systemic therapy side effects P=.020, ES=0.154; QLQ-BR23 symptom scale P=.038, ES=0.124. ### Weekly side-effect incidence Status: mixed Physical, fatigue, and social functioning side-effect frequencies were lower in HIIT, while psychological complaints were higher. Physical P=.016; fatigue P=.015; social P=.043 favoring HIIT. Psychological complaints were more frequent in HIIT, P=.023. ### Pain and sleep disturbances Status: no clear change Pain and sleep-disturbance self-reports were common and not statistically different between groups. Pain frequency P=.877; sleep frequency P=.745. ### Adherence and adverse events Status: mixed Analyzed HIIT participants averaged 79% adherence and no adverse events were reported during assessments or intervention sessions, but dropout from randomization to analysis was high. HIIT adherence 79 +/- 14%, 51/64 sessions; 37 of 56 randomized participants included in final analyses. ## Practical Insights - Walking-based 4 x 4-minute HIIT can be adapted to free-living settings with heart-rate monitoring and remote reporting. - For oncology populations, symptom monitoring and medical selection are integral to protocol translation. - Per-protocol benefits should be interpreted cautiously because dropout was high. - Remote app-based adherence workflows may help clinical exercise participants complete sessions, but technical proficiency matters. ## Limitations - Small analyzed sample. - High dropout rate in both study groups. - Per-protocol analysis only for this publication. - Control was not attention-matched or exercise-dose matched. - Potential co-interventions such as counseling, immunotherapy, or medications were not fully captured. - Technical issues and varied Polar Flow proficiency limited accurate evaluation of intensity. ## Safety And Adherence - No adverse events were reported during assessments or intervention sessions. - All participants reported at least one chemotherapy-related side effect during the study period. - Severe neoadjuvant chemotherapy side effects were among the most frequent reasons for withdrawal. - Participants with contraindications to submaximal aerobic loads were excluded. ## Original Sources - [PubMed](https://pubmed.ncbi.nlm.nih.gov/39548802/) (pubmed) - [DOI](https://doi.org/10.1177/15347354241297385) (doi) - [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569499/) (full text) ## Agent Guidance Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.