Effects of exercise mode and intensity on patient-reported outcomes in cancer survivors: a four-arm intervention trial

Abstract

Purpose: The aim of this study was to compare the effects of different exercise modes (aerobic, resistance) and intensity prescriptions (standard, polarized, undulating) on patient-reported outcomes (PROs) in cancer survivors.

Methods: 107 breast or prostate cancer survivors (52% females, age 58 ± 10 years, 6-52 weeks after primary therapy) performed one out of four training programs, two sessions/week, over 12 weeks: work rate-matched vigorous intensity aerobic training (AT_Standard, n = 28) and polarized intensity aerobic training (AT_Polarized, n = 26) as well as volume-matched moderate intensity resistance training (RT_Standard, n = 26) and daily undulating intensity resistance training (RT_Undulating, n = 27). Health-related quality of life (HRQoL, EORTC-QLQ-C30) and cancer-related fatigue (CRF, MFI-20) were assessed at baseline, at the end of intervention and after a 12-week follow-up without further prescribed exercise.

Results: Over the intervention period, HRQoL-function-scales of the EORTC-QLQ-C30 improved over time (p = .007), but no group*time interaction was observed (p = .185). Similarly, CRF values of the MFI-20 improved over time (p = .006), but no group*time interaction was observed (p = .663). When including the follow-up period and pooling the AT and the RT groups, HRQoL-function-scales developed differently between groups (p = .022) with further improvements in RT and a decline in AT. For CRF no significant interaction was found, but univariate analyses showed a non-significant trend of more sustainable effects in RT.

Conclusions: AT and RT with different work rate-/volume-matched intensity prescriptions elicits positive effects on HRQoL and CRF, without one regimen being significantly superior to another over the intervention period. However, RT might result in more sustainable effects compared to AT over a follow-up period without any further exercise prescription.

Clinical trial registration: The study was registered at clinicaltrials.gov (NCT02883699).

Keywords: Aerobic training; Fatigue; Polarized; Quality of life; Resistance training; Undulating.

Fig. 1

Participant flow chart

Fig. 2

Changes in PRO’s during the intervention period. Mean changes over the intervention period for selected subscales of the EORTC-QLQ-C-30 and the MFI-20. Shown are EORTC-QLQ-C30 global health status (A) EORTC-QLQ-C30 physical function (B) EORTC-QLQ-C30 fatigue (C) (aerobic training standard group (AT_Standard): n = 28; AT_Polarized: n = 26; RT_Standard: n = 26; RT_Undulating: n = 27), MFI-20 general fatigue (D), MFI-20 physical fatigue (E) and MFI-20 reduced activity (F) (AT_Standard: n = 25; AT_Polarized: n = 23; RT_Standard: n = 25; RT_Undulating: n = 23) for the four training groups

Fig. 3

Changes in PRO’s during the follow-up period. Mean changes over the intervention and follow-up period for selected subscales of the EORTC-QLQ-C-30 and the MFI-20. Shown are EORTC-QLQ-C30 global health status (A) EORTC-QLQ-C30 physical function (B) EORTC-QLQ-C30 fatigue (C) (Aerobic Training (AT): n = 47; Resistance Training (RT): n = 49), MFI-20 general fatigue (D), MFI-20 physical fatigue (E) and MFI-20 reduced activity (F) (AT: n = 40; RT: n = 44) for the pooled training groups