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Int J Sports Med 2020; 41(11): 790-797
DOI: 10.1055/a-1147-1513
Clinical Sciences

Concurrent Exercise Interventions in Breast Cancer Survivors with Cancer-related Fatigue

Itiziar Pagola
1   Faculty of Sport Sciences, Universidad Europea de Madrid, Spain
,
Javier S. Morales
1   Faculty of Sport Sciences, Universidad Europea de Madrid, Spain
,
Lidia B. Alejo
1   Faculty of Sport Sciences, Universidad Europea de Madrid, Spain
,
Olga Barcelo
1   Faculty of Sport Sciences, Universidad Europea de Madrid, Spain
,
Marta Montil
1   Faculty of Sport Sciences, Universidad Europea de Madrid, Spain
,
Jesús Oliván
2   School of Physical Activity and Sport Sciences-INEF, Universidad Politecnica de Madrid, Madrid, Spain
,
Alejandro Álvarez-Bustos
3   Department of Medical Oncology, Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Spain
,
Blanca Cantos
3   Department of Medical Oncology, Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Spain
,
Constanza Maximiano
3   Department of Medical Oncology, Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Spain
,
Francisco Hidalgo
1   Faculty of Sport Sciences, Universidad Europea de Madrid, Spain
,
Pedro L. Valenzuela
4   Physiology Unit, Systems Biology Department, University of Alcala de Henares, Madrid, Spain
,
Carmen Fiuza-Luces
5   12th of October Hospital Research Institute, Physiology, Madrid, Spain
,
Alejandro Lucia
1   Faculty of Sport Sciences, Universidad Europea de Madrid, Spain
,
Ana Ruiz-Casado
3   Department of Medical Oncology, Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Spain
› Institutsangaben Funding: This work is supported by the Spanish Ministry of Education, Culture and Sport (contract number FPU14/03435 to JSM); University of Alcalá (contract number FPI2016 to PLV); Universidad Europea de Madrid [2015/UEM05, 2017/UEM14 and 2018/UEM02 and UEM2020/36]; and the Spanish Ministry of Economy and Competitiveness (Fondo de Investigaciones Sanitarias and Fondos FEDER [grant numbers PI15/00558 and PI18/00139 to AL] and Miguel Servet research contract [ref. # CP18/00034 to CFL]).
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Abstract

This study compared the effects of two supervised concurrent training interventions in breast cancer survivors with cancer-related fatigue at baseline. Twenty-three female breast cancer survivors (50±8 years) were randomized to a high- (n=13) or a moderate-intensity (n=10) training program. Both interventions lasted 16 weeks and included the same resistance exercises, but the aerobic component was supervised and more intense in the former (i.e., rating of perceived exertion of 7–8 vs. 6 on a 1–10 scale for the high and moderate-intensity intervention, respectively). The primary endpoint was fatigue perception. Endpoints were assessed at baseline and after 16 weeks. The p-value for statistical significance was set at 0.004 after Bonferroni correction for multiple comparisons. The high-intensity training program increased lower-limb muscle strength significantly (p=0.002) and tended to improve fatigue perception (p=0.006), waist circumference (p=0.013), neutrophil-to-lymphocyte ratio (p=0.028) and some quality of life items (p=0.011). Although the moderate-intensity training program did not provide such benefits in general (i.e., higher p-values for pre vs post-intervention comparisons), no significant differences were found between interventions (all p>0.004). Further research is needed to elucidate if the benefits provided by high-intensity concurrent training are superior to those elicited by moderate-intensity training in breast cancer survivors.

Key words

exercise is medicine - physical activity - high-intensity training - quality of life - body composition - physical fitness

Supplementary Material



Publikationsverlauf

Eingereicht: 17. September 2019

Angenommen: 19. März 2020

Artikel online veröffentlicht:
29. Juni 2020

© 2020. Thieme. All rights reserved.

© Georg Thieme Verlag KG
Stuttgart · New York

 

  • References

  • 1 Bray F, Ferlay J, Soerjomataram I. et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68: 394-424
    CrossrefPubMedGoogle Scholar
  • 2 Allemani C, Weir HK, Carreira H. et al. Global surveillance of cancer survival 1995-2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2). Lancet 2015; 385: 977-1010
    CrossrefPubMedGoogle Scholar
  • 3 Schmidt ME, Chang-Claude J, Vrieling A. et al. Fatigue and quality of life in breast cancer survivors: temporal courses and long-term pattern. J Cancer Surviv 2012; 6: 11-19
    CrossrefPubMedGoogle Scholar
  • 4 Winters-Stone KM, Bennett JA, Nail L. et al. Strength, physical activity, and age predict fatigue in older breast cancer survivors. Oncol Nurs Forum 2008; 35: 815-821
    CrossrefPubMedGoogle Scholar
  • 5 Kilgour RD, Vigano A, Trutschnigg B. et al. Cancer-related fatigue: The impact of skeletal muscle mass and strength in patients with advanced cancer. J Cachexia Sarcopenia Muscle 2010; 1: 177-185
    CrossrefPubMedGoogle Scholar
  • 6 Neil SE, Klika RJ, Garland SJ. et al. Cardiorespiratory and neuromuscular deconditioning in fatigued and non-fatigued breast cancer survivors. Support Care Cancer 2013; 21: 873-881
    CrossrefPubMedGoogle Scholar
  • 7 Cleeland CS, Bennett GJ, Dantzer R. et al. Are the symptoms of cancer and cancer treatment due to a shared biologic mechanism? A cytokine-immunologic model of cancer symptoms. Cancer 2003; 97: 2919-2925
    CrossrefPubMedGoogle Scholar
  • 8 Saligan LN, Olson K, Filler K. et al. The biology of cancer-related fatigue: A review of the literature. Support Care Cancer 2015; 23: 2461-2478
    CrossrefPubMedGoogle Scholar
  • 9 Thornton LM, Andersen BL, Blakely WP. The pain, depression, and fatigue symptom cluster in advanced breast cancer: covariation with the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. Health Psychol 2010; 29: 333-337
    CrossrefPubMedGoogle Scholar
  • 10 Schmidt ME, Semik J, Habermann N. et al. Cancer-related fatigue shows a stable association with diurnal cortisol dysregulation in breast cancer patients. Brain Behav Immun 2016; 52: 98-105
    CrossrefPubMedGoogle Scholar
  • 11 Sha F, Zhuang S, Zhou L. et al. Biomarkers for cancer-related fatigue and adverse reactions to chemotherapy in lung cancer patients. Mol Clin Oncol 2015; 3: 163-166
    CrossrefPubMedGoogle Scholar
  • 12 Ruiz-Casado A, Verdugo AS, Solano MJ. et al. Objectively assessed physical activity levels in Spanish cancer survivors. Oncol Nurs Forum 2014; 41: E12-20
    CrossrefPubMedGoogle Scholar
  • 13 Peel JB, Sui X, Adams SA. et al. A prospective study of cardiorespiratory fitness and breast cancer mortality. Med Sci Sports Exerc 2009; 41: 742-748
    PubMedGoogle Scholar
  • 14 Klassen O, Schmidt ME, Ulrich CM. et al. Muscle strength in breast cancer patients receiving different treatment regimes. J Cachexia Sarcopenia Muscle 2017; 8: 305-316
    CrossrefPubMedGoogle Scholar
  • 15 Caan BJ, Cespedes Feliciano EM, Prado CM. et al. Association of muscle and adiposity measured by computed tomography with survival in patients with nonmetastatic breast cancer. JAMA. Oncol 2018; 4: 798-804
    PubMedGoogle Scholar
  • 16 Christensen JF, Jones LW, Andersen JL. et al. Muscle dysfunction in cancer patients. Ann Oncol 2014; 25: 947-958
    CrossrefPubMedGoogle Scholar
  • 17 Shachar SS, Williams GR, Muss HB. et al. Prognostic value of sarcopenia in adults with solid tumours: A meta-analysis and systematic review. Eur J Cancer 2016; 57: 58-67
    CrossrefPubMedGoogle Scholar
  • 18 Fuller JT, Hartland MC, Maloney LT. et al. Therapeutic effects of aerobic and resistance exercises for cancer survivors: A systematic review of meta-analyses of clinical trials. Br J Sports Med 2018; 52: 1311
    CrossrefPubMedGoogle Scholar
  • 19 Padilha CS, Marinello PC, Galvão DA. et al. Evaluation of resistance training to improve muscular strength and body composition in cancer patients undergoing neoadjuvant and adjuvant therapy: A meta-analysis. J Cancer Surviv 2017; 11: 339-349
    CrossrefPubMedGoogle Scholar
  • 20 Sweegers MG, Altenburg TM, Brug J. et al. Effects and moderators of exercise on muscle strength, muscle function and aerobic fitness in patients with cancer: A meta-analysis of individual patient data. Br J Sports Med 2019; 53: 812
    CrossrefPubMedGoogle Scholar
  • 21 Toohey K, Pumpa K, McKune A. et al. High-intensity exercise interventions in cancer survivors: a systematic review exploring the impact on health outcomes. J Cancer Res Clin Oncol 2018; 144: 1-12
    CrossrefPubMedGoogle Scholar
  • 22 Moher D, Schulz KF, Altman DG. et al. The CONSORT statement: Revised recommendations for improving the quality of reports of parallel group randomized trials. BMC Med Res Methodol 2001; 1: 2
    CrossrefPubMedGoogle Scholar
  • 23 Chan AW, Tetzlaff JM, Gøtzsche PC. et al. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ 2013; 346: e7586
    CrossrefPubMedGoogle Scholar
  • 24 Harriss DJ, Macsween A, Atkinson G. Ethical standards in sport and exercise science research: 2020 update. Int J Sports Med 2019; 40: 813-817
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 25 World Health Organization W. Global recommendations on physical activity for health. In: http://apps.who.int/iris/handle/10665/44399; 2010
    PubMed
  • 26 Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982; 14: 377-381
    PubMedGoogle Scholar
  • 27 Santana Sosa E, Groeneveld IF, Gonzalez-Saiz L. et al. Intrahospital weight and aerobic training in children with cystic fibrosis: A randomized controlled trial. Med Sci Sports Exerc 2012; 44: 2-11
    CrossrefPubMedGoogle Scholar
  • 28 Baró E, Carulla J, Cassinello J. et al. Psychometric properties of the Perform Questionnaire: A brief scale for assessing patient perceptions of fatigue in cancer. Support Care Cancer 2011; 19: 657-666
    CrossrefPubMedGoogle Scholar
  • 29 Santos-Lozano A, Marín PJ, Torres-Luque G. et al. Technical variability of the GT3X accelerometer. Med Eng Phys 2012; 34: 787-790
    CrossrefPubMedGoogle Scholar
  • 30 Lucía A, Pardo J, Durántez A. et al. Physiological differences between professional and elite road cyclists. Int J Sports Med 1998; 19: 342-348
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 31 Ruiz-Ruiz J, Mesa JL, Gutiérrez A. et al. Hand size influences optimal grip span in women but not in men. J Hand Surg Am 2002; 27: 897-901
    CrossrefPubMedGoogle Scholar
  • 32 Arraras J, Illarramendi J, Valerdi J. El Cuestionario de Calidad de Vida para cáncer de la EORTC, QLQ-C30. Estudio estadístico de validación con una muestra española. Revista de Psicología de la Salud 1995; 7: 13-33
    PubMedGoogle Scholar
  • 33 Arraras J, Tejedor M, Illarramendi J. et al. El cuestionario de calidad de vida para cáncer de mama de la EORTC, QLQ-BR23. Estudio psicométrico con una muestra española. Psicol Conduct 2001; 9: 81-98
    PubMedGoogle Scholar
  • 34 Rogers LQ, Vicari S, Trammell R. et al. Biobehavioral factors mediate exercise effects on fatigue in breast cancer survivors. Med Sci Sports Exerc 2014; 46: 1077-1088
    CrossrefPubMedGoogle Scholar
  • 35 Cella D, Davis K, Breitbart W. et al. Cancer-related fatigue: prevalence of proposed diagnostic criteria in a United States sample of cancer survivors. J Clin Oncol 2001; 19: 3385-3391
    CrossrefPubMedGoogle Scholar
  • 36 Lipsett A, Barrett S, Haruna F. et al. The impact of exercise during adjuvant radiotherapy for breast cancer on fatigue and quality of life: A systematic review and meta-analysis. Breast 2017; 32: 144-155
    CrossrefPubMedGoogle Scholar
  • 37 Mijwel S, Backman M, Bolam KA. et al. Adding high-intensity interval training to conventional training modalities: Optimizing health-related outcomes during chemotherapy for breast cancer: the OptiTrain randomized controlled trial. Breast Cancer Res Treat 2018; 168: 79-93
    CrossrefPubMedGoogle Scholar
  • 38 Adams SC, DeLorey DS, Davenport MH. et al. Effects of high-intensity interval training on fatigue and quality of life in testicular cancer survivors. Br J Cancer 2018; 118: 1313-1321
    CrossrefPubMedGoogle Scholar
  • 39 Dibaba DT, Ogunsina K, Braithwaite D. et al. Metabolic syndrome and risk of breast cancer mortality by menopause, obesity, and subtype. Breast Cancer Res Treat 2019; 174: 209-218
    CrossrefPubMedGoogle Scholar
  • 40 Azab B, Bhatt VR, Phookan J. et al. Usefulness of the neutrophil-to-lymphocyte ratio in predicting short- and long-term mortality in breast cancer patients. Ann Surg Oncol 2012; 19: 217-224
    CrossrefPubMedGoogle Scholar
  • 41 Fu TC, Wang CH, Lin PS. et al. Aerobic interval training improves oxygen uptake efficiency by enhancing cerebral and muscular hemodynamics in patients with heart failure. Int J Cardiol 2013; 167: 41-50
    CrossrefPubMedGoogle Scholar
  • 42 Scott JM, Zabor EC, Schwitzer E. et al. Efficacy of exercise therapy on cardiorespiratory fitness in patients with cancer: A systematic review and meta-analysis. J Clin Oncol 2018; 36: 2297-2305
    CrossrefPubMedGoogle Scholar