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

• Published in: Breast cancer research and treatment Vol. 169; no. 1; pp. 93 - 103
• Main Authors: Mijwel, Sara, Backman, Malin, Bolam, Kate A., Olofsson, Emil, Norrbom, Jessica, Bergh, Jonas, Sundberg, Carl Johan, Wengström, Yvonne, Rundqvist, Helene
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-05-2018; Springer; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Body Composition - physiology; Body mass; Breast cancer; Breast Neoplasms - complications; Breast Neoplasms - drug therapy; Breast Neoplasms - physiopathology; Cancer research; Cardiorespiratory fitness; Chemotherapy; Clinical Trial; Evidence-based medicine; Exercise; Exercise therapy; Fatigue; Fatigue - chemically induced; Fatigue - etiology; Fatigue - physiopathology; Fatigue - therapy; Female; Hand Strength; Health aspects; Hemoglobin; Hemoglobins; High-Intensity Interval Training; Humans; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Middle Aged; Muscle strength; Muscle, Skeletal - physiology; Obesity - complications; Obesity - physiopathology; Obesity - therapy; Oncology; Overweight - complications; Overweight - physiopathology; Overweight - therapy; Pain; Pain management; Physical fitness; Physiological aspects; Physiology; Pressure; Pressure-pain threshold; Resistance Training; Surgery; High-intensity interval training; Pressure-pain threshold; Chemotherapy; Breast cancer
• ISSN: 0167-6806; 1573-7217; 1573-7217
• DOI: 10.1007/s10549-018-4663-8

Background
Advanced therapeutic strategies are often accompanied by significant adverse effects, which warrant equally progressive countermeasures. Physical exercise has proven an effective intervention to improve physical function and reduce fatigue in patients undergoing chemotherapy. Effects of high-intensity interval training (HIIT) in this population are not well established although HIIT has proven effective in other clinical populations. The aim of the OptiTrain trial was to examine the effects of concurrent resistance and high-intensity interval training (RT-HIIT) or concurrent moderate-intensity aerobic and high-intensity interval training (AT-HIIT), to usual care (UC) on pain sensitivity and physiological outcomes in patients with breast cancer during chemotherapy.
Methods
Two hundred and forty women were randomized to 16 weeks of RT-HIIT, AT-HIIT, or UC. Outcomes: cardiorespiratory fitness, muscle strength, body mass, hemoglobin levels, and pressure-pain threshold.
Results
Pre- to post-intervention, RT-HIIT (ES = 0.41) and AT-HIIT (ES = 0.42) prevented the reduced cardiorespiratory fitness found with UC. Handgrip strength (surgery side: RT-HIIT vs. UC: ES = 0.41, RT-HIIT vs. AT-HIIT: ES = 0.28; non-surgery side: RT-HIIT vs. UC: ES = 0.35, RT-HIIT vs. AT-HIIT: ES = 0.22) and lower-limb muscle strength (RT-HIIT vs. UC: ES = 0.66, RT-HIIT vs. AT-HIIT: ES = 0.23) were significantly improved in the RT-HIIT. Increases in body mass were smaller in RT-HIIT (ES = − 0.16) and AT-HIIT (ES = − 0.16) versus UC. RT-HIIT reported higher pressure-pain thresholds than UC (trapezius: ES = 0.46, gluteus: ES = 0.53) and AT-HIIT (trapezius: ES = 0.30).
Conclusion
Sixteen weeks of RT-HIIT significantly improved muscle strength and reduced pain sensitivity. Both exercise programs were well tolerated and were equally efficient in preventing increases in body mass and in preventing declines in cardiorespiratory fitness. These results highlight the importance of implementing a combination of resistance and high-intensity interval training during chemotherapy for women with breast cancer.