Adding high-intensity interval training to conventional training modalities: optimizing health-related outcomes during chemotherapy for breast cancer: the OptiTrain randomized controlled trial

• Published in: Breast cancer research and treatment Vol. 168; no. 1; pp. 79 - 93
• Main Authors: Mijwel, Sara, Backman, Malin, Bolam, Kate A., Jervaeus, Anna, Sundberg, Carl Johan, Margolin, Sara, Browall, Maria, Rundqvist, Helene, Wengström, Yvonne
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-02-2018; Springer; Springer Nature B.V
• Subjects: Adult; Antineoplastic Agents - adverse effects; Breast cancer; Breast Neoplasms - complications; Breast Neoplasms - drug therapy; Breast Neoplasms - pathology; Breast Neoplasms - rehabilitation; Cancer research; Chemotherapy; Clinical Trial; Clinical trials; Cognitive ability; Concurrent training; Exercise; Exercise therapy; Exercise Therapy - methods; Fatigue; Fatigue - diagnosis; Fatigue - epidemiology; Fatigue - etiology; Fatigue - rehabilitation; Female; Health-related quality of life; High-Intensity Interval Training; Humans; Medical schools; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Middle Aged; NCT; NCT02522260; Oncology; Pain; Physical Fitness; Quality of Life; Rehabilitation; Symptom burden; Treatment Outcome; Välbefinnande vid långvariga hälsoproblem (WeLHP); Wellbeing in long-term health problems (WeLHP); Concurrent training; High-intensity interval training; Health-related quality of life; Chemotherapy; Breast cancer; Symptom burden
• ISSN: 0167-6806; 1573-7217; 1573-7217
• DOI: 10.1007/s10549-017-4571-3

Purpose
Exercise training is an effective and safe way to counteract cancer-related fatigue (CRF) and to improve health-related quality of life (HRQoL). High-intensity interval training has proven beneficial for the health of clinical populations. The aim of this randomized controlled trial was to compare the effects of resistance and high-intensity interval training (RT–HIIT), and moderate-intensity aerobic and high-intensity interval training (AT–HIIT) to usual care (UC) in women with breast cancer undergoing chemotherapy. The primary endpoint was CRF and the secondary endpoints were HRQoL and cancer treatment-related symptoms.
Methods
Two hundred and forty women planned to undergo chemotherapy were randomized to supervised RT–HIIT, AT–HIIT, or UC. Measurements were performed at baseline and at 16 weeks. Questionnaires included Piper Fatigue Scale, EORTC-QLQ-C30, and Memorial Symptom Assessment Scale.
Results
The RT–HIIT group was superior to UC for CRF: total CRF (
p
 = 0.02), behavior/daily life (
p
 = 0.01), and sensory/physical (
p
 = 0.03) CRF. Role functioning significantly improved while cognitive functioning was unchanged for RT–HIIT compared to declines shown in the UC group (
p
 = 0.04). AT–HIIT significantly improved emotional functioning versus UC (
p
 = 0.01) and was superior to UC for pain symptoms (
p
 = 0.03). RT–HIIT reported a reduced symptom burden, while AT–HIIT remained stable compared to deteriorations shown by UC (
p
 < 0.01). Only RT–HIIT was superior to UC for total symptoms (
p
 < 0.01).
Conclusions
16 weeks of resistance and HIIT was effective in preventing increases in CRF and in reducing symptom burden for patients during chemotherapy for breast cancer. These findings add to a growing body of evidence supporting the inclusion of structured exercise prescriptions, including HIIT, as a vital component of cancer rehabilitation.
Trial registration
Clinicaltrials.gov Registration Number: NCT02522260.