What is the clinical evidence from this study?

Study design: RCT. Population: Breast Cancer (n=30). Intervention: High intensity interval training (HIIT) vs. Non-exercise control. Primary outcome: Feasibility (completing an average of 70% of weekly minutes and attending 70% of exercise sessions).

July 3, 2019Open Access

Feasibility of high intensity interval training in patients with breast Cancer undergoing anthracycline chemotherapy: a randomized pilot trial

Key Result

An 8-week high intensity interval training intervention was feasible in breast cancer patients receiving anthracycline chemotherapy, with 80% of participants meeting adherence criteria.

Study Design

Type

RCT (n=30)

Blinding

Open-label

Randomization

1:1

Multicenter

Yes

Structured PICO

Is an 8-week high intensity interval training (HIIT) intervention feasible and does it maintain VO2max in breast cancer patients undergoing anthracycline-based chemotherapy?

Population

30 sedentary women with early-stage breast cancer undergoing anthracycline-based chemotherapy participated in an 8-week pilot trial to assess the feasibility of high-intensity interval training.

Intervention

8-week High Intensity Interval Training (HIIT) on a stationary bike, 3 times weekly for 30 minutes per session. Each session included a 5-min warm-up at 10% peak power output (PPO), 20-min HIIT (7 intervals of 1-min at 90% PPO followed by 2-min at 10% PPO), and a 5-min cool-down at 10% PPO.

Comparator

Non-exercise control group asked to maintain their current level of physical activity.

Outcome

Feasibility, defined as >50% of participants completing both an average of 70% of weekly minutes (63/90 min) and attending 70% of exercise sessions (17/24 sessions) over 8 weeks.surrogate

An 8-week HIIT intervention is feasible and prevents the significant decline in cardiorespiratory fitness (VO2max) typically observed in breast cancer patients receiving cardiotoxic anthracycline chemotherapy.

Limitations

Small sample size as a pilot study
Possible recruitment bias due to patients declining participation from lack of interest in exercise during chemotherapy
Not adequately powered to find statistically significant improvements in VO2max changes

Abstract

Anthracycline-based chemotherapy is associated with reduced cardiorespiratory fitness in breast cancer patients. High intensity interval training (HIIT) induces greater benefits on cardiorespiratory fitness than moderate continuous aerobic exercise in patients with heart failure. The study purpose was to determine whether a HIIT intervention is a feasible exercise strategy for breast cancer patients undergoing anthracycline-based chemotherapy. Thirty women were randomized to either HIIT or non-exercise control group (CON). Participants performed a maximal cycling fitness test to measure peak power output during maximal oxygen uptake (VO2max). The HIIT group participated in an 8-week HIIT intervention occurring 3 times weekly. Feasibility was calculated by computing (1) the average weekly minutes of HIIT over 8 weeks and (2) the number of sessions attended and multiplied by 100 (percentage of sessions). The intervention was considered feasible if more than 50% of participants completed both an average of 70% of weekly minutes (63/90 min) and attended 70% exercise sessions (17/24 sessions). Participants were 46.9 ± 9.8 (mean ± SD) years old, diagnosed with clinical stage II (30%) or III (63%) breast cancer. The average weekly minutes of exercise completed was 78 ± 5.1 out of 90 min. Twelve of 15 participants met both feasibility criteria, attending 19.2 ± 2.1 out of 24 sessions (82.3%). VO2max was maintained (19.7 ± 8.7 to 19.4 ± 6.6 ml/kg/min) in HIIT group (p = 0.94) while there was a significant decrease in VO2max (18.7 ± 7.1 to 16.1 ± 6.0 ml/kg/min) in CON group from baseline to 8 weeks (p = 0.001). HIIT is a feasible exercise intervention to maintain VO2max in breast cancer patients receiving anthracycline-based chemotherapy. The protocol and informed consent were approved by the institutional IRB (HS-12-00227) and registered ( ClinicalTrials.gov NCT02454777; date of registration: May 272,015).

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