What is the clinical evidence from this study?

Study design: Other. Population: Breast cancer (n=52). Intervention: Combined cardiovascular and strength exercise training. Primary outcome: Change in predicted VO2peak (mL/kg/min) (95% CI 0.1-4.3).

November 23, 2021Open Access

Low-frequency exercise training improves cardiovascular fitness and strength during treatment for breast cancer: a single-arm intervention study

Key Result

A flexible exercise program of 1.2 sessions per week significantly improved predicted VO2peak by 2.2 mL/kg/min and increased isometric strength in females undergoing treatment for breast cancer.

Structured PICO

Does a flexible, low-frequency exercise training program improve cardiovascular fitness and strength in females undergoing treatment for recently diagnosed breast cancer?

Population

52 biological females ≥ 18 years with recently diagnosed stage I–IIIB breast cancer undergoing treatment, mean age 53 ± 10 years, overweight (BMI 27.5 ± 5.4 kg/m²).

Intervention

24 sessions of supervised combined cardiovascular and strength training, targeted at 2 sessions/week over 12 weeks, but expanded as needed to accommodate missed sessions (median frequency 1.2 sessions/week over median 20 weeks).

Outcome

Cardiovascular fitness and isometric strengthsurrogate

A flexible, low-frequency exercise program (median 1.2 sessions/week) during active breast cancer treatment significantly improved cardiovascular fitness and strength while maintaining body composition and metabolic health.

Limitations

Heterogeneous group of participants regarding menopausal status and treatment type
Lack of a usual care reference group (single-arm design)
Small sample size increasing susceptibility to type I errors

Abstract

Abstract Aerobic and resistance exercise during and after cancer treatment are important for health-related outcomes, however treatment-specific barriers may inhibit adherence. We explored the effect of lower-frequency exercise training on fitness, body composition, and metabolic markers (i.e. glucose and lipids) in a group of recently diagnosed breast cancer patients. Fifty-two females ≥ 18 years with stage I–IIIB breast cancer were instructed to attend 2 cardiovascular and strength training sessions/week over 12 weeks, but program length was expanded as needed to accommodate missed sessions. Pre- and post-intervention, we measured: (1) cardiovascular fitness, (2) isometric strength, (3) body composition (dual-energy X-ray absorptiometry), and (4) fasting glucose, insulin, c-peptide, and lipids. Pre-intervention, participants were 53 ± 10 years old (mean ± SD) and overweight (BMI: 27.5 ± 5.4 kg m −2 , 40.1 ± 6.5% body fat). Forty participants completed the program over a median 20 weeks (range: 13–32 weeks, median frequency: 1.2 sessions/week), over which predicted VO 2 peak improved by 7% (2.20.1–4.4 mL/kg/min) (delta95% CI), and strength increased by 7–9% (right arm: 2.30.1–4.5 N m; right leg: 7.92.1–13.7 N m; left leg: 7.81.9–13.7 N m). Body composition and metabolic markers were unchanged. An exercise frequency of 1.2 sessions/week stimulated significant improvements in fitness, and may represent a practical target for patients during active treatment.

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