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

Abstract

BackgroundAdvanced 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.MethodsTwo 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.ResultsPre- 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).ConclusionSixteen 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.

Exercise training during chemotherapy preserves skeletal muscle fiber area, capillarization, and mitochondrial content in patients with breast cancer

“…An additional limitation is that the current approach does not allow for separating the effects of anthracyclines from those of taxanes. However, a subgroup analysis in the general trial showed similar effects on muscle strength and cardiorespiratory fitness regardless of chemotherapy regimen (18). The low attendance rate in the RT-HIIT group may have underestimated the potential effects of an RT-HIIT regimen in patients with breast cancer.…”

“…Exercise session attendance was calculated as the mean of the individual percentages (attended exercise sessions divided by the total number of sessions). Muscle strength was measured by isometric midthigh pull as described previously (18). Cancer-related fatigue was selfassessed at baseline and at 16 wk using the EORTC QLQ-C30 questionnaire (version 3.0) (31).…”

“…In patients with breast cancer, physical exercise counteracts the loss of muscle strength experienced after treatment (15). One training modality that induces significant muscle adaptation and health benefits in a time-efficient manner is high-intensity interval training (HIIT) (16), which has been trialed safely in patients with breast cancer (17), including in the current trial during chemotherapy (18).…”

“…We recently found beneficial effects on lower limb muscular strength and aerobic fitness in the 16 wk Opti-Train RCT intervention comparing moderate-intensity aerobic training (AT) combined with HIIT (AT-HIIT) and RT combined with HIIT (RT-HIIT) with usual care (UC) (18).…”

“…The aim of this study was to compare the effects of AT-HIIT and RT-HIIT with the effects of UC on skeletal muscle mitochondrial markers, antioxidant capacity, muscle fiber size and type, SC presence, and capillarization in a subset of patients with breast cancer undergoing chemotherapy who were part of the Optitrain trial (18).…”