Effectiveness of HIIT in patients with cancer or cancer survivors: An umbrella and mapping review with meta‐meta‐analysis

Abstract

Methods: An umbrella review and meta-meta-analysis (MMA) was performed.A systematic search was conducted in MEDLINE, EMBASE, Cochrane Database, CINAHL, Scopus, SPORTDiscus, and Web of Science until August 2021. Article selection, quality assessment, and risk of bias assessment were performed by two independent reviewers. The MMA were performed with a random-effects model and the summary statistics were presented in the form of forest plot with a weighted compilation of all standardized mean differences (SMD) and corresponding 95% confidence interval (CI).Results: Seven systematic reviews were included. Regarding CRF, the addition of HIIT to cancer treatment showed statistically significant differences with a small clinical effect, compared with adding other treatments (SMD = 0.45; 95% CI 0.24 to 0.65). There was no significant difference when compared with adding moderate-intensity continuous training (MICT) (SMD = 0.23; 95% CI −0.04 to 0.50). QoL showed positive results although with some controversy. Adherence to HIIT intervention was high, ranging from 54% to 100%. Regarding adverse effects, most of the systematic reviews reported none, and in the cases in which they occurred, they were mild. Conclusion:In conjunction with first-choice cancer treatment, HIIT has been shown to be an effective intervention in terms of CRF and QoL, as well as having optimal adherence rate. In addition, the implementation of HIIT in patients with cancer or cancer survivors is safe as it showed no or few adverse effects.

Effects of High-Intensity Interval Training and Combined High-Intensity Interval Training Programs on Cancer-Related Fatigue and Cancer Pain: A Systematic Review and Meta-analysis

“…Recent published meta-analysis has proven that HIIT is a safe and feasible intervention in cancer patients and cancer survivors (29,64). There are multiple HIIT and combined HIIT training protocols that can be used for cancer patients and survivors.…”

“…High-intensity interval training (HIIT) is a structured and enhanced interval training involving brief, high-intensity exercise (ranging from 85% to 250% VO 2max for 6 s to 4 min) separated by brief bouts of low-intensity aerobic rest (ranging from 20% to 40% VO 2 max for 10 s to 5 min) (25,26). Despite early concerns, HIIT is an effective intervention in improving physical fitness and patient-reported health-related outcomes, and it has been proven to be a safe and feasible treatment for cancer patients (27)(28)(29). Including HIIT in a training program implies that greater health-enhancing benefits could be gained in less time, making HIIT a more time-efficient and attractive option.…”

Benefits beyond cardiometabolic health: the potential of frequent high intensity ‘exercise snacks’ to improve outcomes for those living with and beyond cancer

“…Suggested physiological mechanisms include decreases in systemic inflammation (Petersen & Pedersen, 2005), reductions in body fat (McTiernan, 2008), decreases in insulin‐like growth factor‐1, reductions in the circulating concentrations of sex hormones, improved immune function (Dethlefsen, Pedersen et al., 2017; Farley et al., 2022), and/or reduced oxidative stress (Guinan et al., 2013). Within the broader exercise oncology literature, a number of RCT's have examined the influence of HIIT on various health outcomes; the findings from these studies show that HIIT improves cardiorespiratory fitness, quality of life and body composition in a number of different cancer populations and that many of these changes occur in only 4 weeks of training (Devin et al., 2016; Herranz‐Gómez et al., 2022). However, in addition to these longer‐term benefits that occur with training, there are also acute, transient responses to discrete bouts of exercise that have been shown to temporarily reduce the growth of cancer cells in vitro .…”

High‐intensity interval training in breast cancer patients: A systematic review and meta‐analysis

“…Systematic reviews investigating the impact of HIIT in cancer patients, including a significant number of breast cancer cases, have consistently reported improved cardiorespiratory fitness and HRQoL 21–23 . However, to date, no review has exclusively examined the effects of HIIT in patients with breast cancer.…”

“…19,20 Systematic reviews investigating the impact of HIIT in cancer patients, including a significant number of breast cancer cases, have consistently reported improved cardiorespiratory fitness and HRQoL. [21][22][23] However, to date, no review has exclusively examined the effects of HIIT in patients with breast cancer. Therefore, in this study, we aim to integrate and analyze all existing articles on HIIT exercise interventions in breast cancer patients.…”