Effects of high-intensity interval training on fatigue and quality of life in testicular cancer survivors

Abstract

Background: Testicular cancer survivors (TCS) are at increased risk of cancer-related fatigue (CRF), psychosocial impairment, and poor mental health-related quality of life (HRQoL). Here, we examine the effects of high-intensity interval training (HIIT) on patient-reported outcomes (PROs) in TCS. Secondarily, we explore cardiorespiratory fitness as a mediator of intervention effects and select baseline characteristics as moderators of intervention effects.

Methods: TCS (n = 63) were randomly assigned to 12 weeks of supervised HIIT or usual care (UC). PROs included CRF, depression, anxiety, stress, self-esteem, sleep quality, and HRQoL assessed at baseline, post-intervention, and 3-month follow-up.

Results: TCS (median 7 years postdiagnosis) completed 99% of training sessions and achieved 98% of target training intensity. ANCOVA revealed that, compared to UC, HIIT significantly improved post-intervention CRF (p = 0.003), self-esteem (p = 0.029), and multiple HRQoL domains (ps ≤ 0.05). Effects on CRF (p = 0.031) and vitality (p = 0.015) persisted at 3-month follow-up. Cardiorespiratory fitness changes mediated CRF and HRQoL improvements. CRF effects were larger for TCS with an inactive lifestyle, lower fitness, higher testosterone, and clinical fatigue at baseline.

Conclusions: HIIT significantly improves CRF and HRQoL in TCS. Mediation by cardiorespiratory fitness and moderation by clinical characteristics suggests opportunities for targeted exercise interventions to optimise PROs in TCS.

Fig. 1

Participant flow through the HIITTS trial. Dx diagnosis, CVD cardiovascular disease, HIIT high-intensity aerobic interval training, ECG electrocardiogram, PRO patient-reported outcome

Fig. 2

Effects of 12 weeks of HIIT on a) CRF and b) vitality at post-intervention and 3-month follow-up in TCS. HIIT high-intensity aerobic interval training, CRF cancer-related fatigue, TCS testicular cancer survivors, FACT-F functional assessment of cancer therapy fatigue scale, UC usual care, SF-36 short form 36. ^* Post-intervention and 3-month follow-up difference values were adjusted for baseline value of the outcome, age, treatment exposure, and time since treatment

Fig. 3

Moderator effects of baseline a) VO_2peak and b) testosterone on CRF at post-intervention and baseline c) aerobic exercise and d) CRF on CRF at 3-month follow-up. VO_2peak peak aerobic exercise capacity, CRF cancer-related fatigue, FACT-F functional assessment of cancer therapy fatigue scale, UC usual care, HIIT high-intensity aerobic interval training