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

Abstract

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.

Keywords: Breast cancer; Chemotherapy; High-intensity interval training; Pressure-pain threshold.

Fig. 1

Effects of concurrent resistance and high-intensity interval training (RT-HIIT) and moderate-intensity aerobic and high-intensity interval training (AT-HIIT) versus usual care (UC) on physiological outcomes: a estimated VO_2peak, b isometric mid-thigh pull, c handgrip strength surgery side, d handgrip strength non-surgery side, e body mass, and f hemoglobin levels. *p < 0.05 at post versus pre measurement; ^†p < 0.05 compared to UC; ^§p < 0.05 between RT-HIIT and AT-HIIT. Data is presented as mean and standard error of the mean. No statistically significant differences were found at baseline between groups

Fig. 2

Pressure-pain thresholds (PPT) for a trapezius muscle, b gluteus muscle. RT-HIIT resistance and high-intensity interval training, AT-HIIT moderate-intensity aerobic and high-intensity interval training, UC usual care. *p < 0.05 at post versus pre measurement; ^†p < 0.05 compared to UC; ^§p < 0.05 between RT-HIIT and AT-HIIT. Data is presented as mean and standard error of the mean. No statistically significant differences were found at baseline between groups