The impact of maximal strength training on quality of life among women with breast cancer undergoing treatment

Abstract

Summary. Cancer rehabilitation programs mainly involve endurance training while little attention has been paid to strength training. Breast cancer (BC) patients lose muscle strength while undergoing adjuvant treatment, thus affecting daily activities and quality of life. Maximal strength training, with an emphasis on velocity in the concentric phase, improves maximal strength and muscle force development characteristics. However, the effect of maximal strength training on quality of life for BC patients undergoing treatment remains elusive. Consequently, the aim of this study was to evaluate the effectiveness of maximal strength training in Health related quality of life in women with newly diagnosed BC. Materials and Methods: 55 BC patients with disease stage I–III were randomized into a training group and control group. The training group performed maximal strength training twice a week for 3 months, whereas the control group followed prescribed treatment without strength training. Overall quality of life was measured by The European Organization for Research and Treatment of Cancer Core Quality of life Questionnaire-C30 and additional BC module BR23 before and after the intervention. Results: The results obtained from pre-tests and those obtained after 3 months of intervention revealed that patients in the training group significantly increased one repetition maximum, by 20.4 kg (20%) (p = 0.001, d = 0.9). Simultaneously, statistically significant alterations were observed in this variable for the control group, one repetition maximum decreased by 8.9 kg (9%) (p = 0.001, d = 0.5). The overall quality of life improved significantly by 13% for the training group with large effect (p = 0.002, d = 0.6), but no relevant changes were observed in the control group (p = 0.44, d = 0.2). Results revealed remarkable changes in overall quality of life after 3-month post-test period between the two groups with large effect (p = 0.002, d = 0.9). The training sessions had helped in diminishing the sense of fatigue by 24% (p = 0.03, d = 0.6), while it had got worse by 25% (p = 0.02, d = 0.4) for the control group. Again, the data on large effect were noticed to differ between the groups (p = 0.01, d = 0.6). Conclusion: Maximal strength training for BC patients was well tolerated, safe and feasible and showed strength improvements that led to improved muscle strength and improved overall quality of life. These data certainly support the therapeutic role for maximal strength training in the treatment of BC.

Different Methods of Physical Training Applied to Women Breast Cancer Survivors: A Systematic Review

“…In similar studies, an increase in the muscle strength of WSBC was found after 12 weeks of high-intensity resistance exercise (Cešeiko et al, 2019;Santagnello et al, 2020). Similar results were observed in elderly survivors of BC who performed 16 weeks of resistance exercise at a high intensity (Serra et al, 2018).…”

“…Moderate to high-intensity resistance exercises were also used as an intervention (Steindorf et al, 2014;Hagstrom et al, 2015;Cešeiko et al, 2019). Additionally, two types of interventions based on resistance exercises were implemented, which differed only in terms of the intensity (low and high); they were compared with each other, and the intensity was inversely proportionally related to the number of repetitions (Cormie et al, 2013).…”

Female cancer survivors are more likely to be at high risk of malnutrition and meet the threshold for clinical importance for a number of quality of life subscales

“…This can be a result of the tumour itself, 18 a feature of muscle abnormality, 19 an outcome of the treatment prescribed 20 or a consequence of cancer‐related fatigue 21 . It can also be a result of ageing, malnutrition and a lack of physical activity 19,22,23 . Muscle strength as a nutritional parameter is increasingly being used in intervention studies 24 and as a predictor of mortality 25 .…”

“…21 It can also be a result of ageing, malnutrition and a lack of physical activity. 19,22,23 Muscle strength as a nutritional parameter is increasingly being used in intervention studies 24 and as a predictor of mortality. 25 In advanced cancer patients (n = 203) a low handgrip strength (HGS) has been associated with a lower body mass index (BMI), a greater occurrence of sarcopenia and a lower QOL as measured by the McGill Questionnaire.…”

Physical Functionality of the Upper Limb after Breast Cancer Surgery in Southern Brazilian Survivors: Cross-Sectional Study

“…Oncoplastic surgery is the primary treatment for breast cancer, and may be preceded by neoadjuvant chemotherapy and target therapy treatments, and followed by adjuvant radiotherapy, chemotherapy, target therapy or hormone therapy, these treatments are intended to interfere in the progression or prevent breast neoplasm recurrence 1,2. Despite the development of new surgical techniques and the success of adjuvant or neoadjuvant treatments, some consequences are identified and can lead to functional physical impairment in women, affecting the surgery side upper limb, shoulder range of motion, causing muscle weakness, pain, loss of upper limb functionality, decreased proprioception and lymphedema [3][4][5][6][7][8] . These treatment consequences can cause hypomobility of the upper limb, implicating in physical and psychological distress in women's lives, decreasing the performance of daily living activities 9,10. Therefore, investigations of shoulder range of motion, strength, pain, upper limb functionality, and proprioception after breast cancer surgery are essential, considering the possibility of permanent weakness of the muscles from the breast and the shoulder girdle, or temporary weakness of the anterior serratus, as well as other upper limb muscles 11 .…”