Effects of Detraining on the Functional Capacity of Previously Trained Breast Cancer Survivors

Abstract

The purpose of this study was to assess the effects of a relatively short (8-weeks) period of detraining on cardiorespiratory capacity, dynamic strength endurance, task specific functional muscle capacity and quality of life (QOL) of breast cancer survivors who had previously undergone a combined supervised (aerobic and resistance) training program. Eleven women survivors of stage I - II ductal breast carcinoma (47 ± 7 yrs) entered the study and performed a battery of tests (including anthropometric evaluation, a graded cycle ergometer test, tests of strength endurance [leg and bench press] and the sit-stand test) and completed a specific QOL questionnaire (EORTC‐C30) at three time points: i) before, ii) after an exercise program (including aerobic and resistance exercises) of 8-weeks duration, and iii) after a subsequent 8-weeks period of training cessation. Training-induced improvements in strength endurance, muscle functional capacity (sit-stand test) and QOL were not significantly changed after detraining (p > 0.05 for post-training vs. detraining comparisons). The lack of significant loss in muscle strength endurance occurred despite significant losses in estimated total muscle mass after detraining (27.3 ± 2.4 kg) compared with post-training (28.5 ± 2.9 kg). In contrast, cardiorespiratory capacity was significantly decreased during detraining (V·O_2peak of 29.0 ± 4.6 vs. 22.7 ± 3.9 ml · kg ^-1 · min^-1 at post-training vs. detraining, p < 0.01). In conclusion, cancer survivors who have participated in a combined training program can retain some of the training gains (particularly improved QOL and muscle strength endurance/functional performance) after a relatively short duration detraining period.

Key words

V·O_2peak - exercise - disease - resistance - quality of life - sit-stand test

References

• 1 Aaronson N K, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez N J, Filiberto A, Flechtner H, Fleishman S B, Ddehaes J CJM, Kaasa S, Klee M, Osoba D, Razavi D, Rofe P B, Schraub S, Sneeuw K, Sullivan M, Takeda F. The European Organization for Research and Treatment of Cancer QLQ‐C30: a quality-of-life instrument for use in international clinical trials in oncology.  J Natl Cancer Inst. 1993;  85 365-376
• 2 Atkinson G, Drust B. Seasonal rhythms and exercise.  Clin Sports Med. 2005;  24 e25-e34 xii-xiii
• 3 Arraras J I, Arias F, Tejedor M, Pruja E, Marcos M, Martinez E, Valerdi J. The EORTC QLQ‐C30 (version 3.0) quality of life questionnaire: validation study for Spain with head and neck cancer patients.  Psychooncology. 2002;  11 249-256
• 4 Berglund G, Bolund C, Fornander T, Rutqvist L E, Sjoden P O. Late effects of adjuvant chemotherapy and postoperative radiotherapy on quality of life among breast cancer patients.  Eur J Cancer. 1991;  27 1075-1081
• 5 Courneya K S. Exercise in cancer survivors: and overview of research.  Med Sci Sports Exerc. 2003;  35 1846-1852
• 6 Day J R, Rossiter H B, Coats E M, Skasick A, Whipp B J. The maximally-attainable V·O₂ during exercise in humans: the peak vs. maximum issue.  J Appl Physiol. 2003;  95 1901-1907
• 7 Donnelly A E, Clarkson P M, Maughan R J. Exercise-induced muscle damage: effects of light exercise on damaged muscle.  Eur J Appl Physiol. 1992;  64 350-353
• 8 Elliott K J, Sale C, Cable N T. Effects of resistance training and detraining on muscle strength and blood lipid profiles in postmenopausal women.  Br J Sports Med. 2002;  36 340-344
• 9 Fayers P M, Aaronson N K, Bjordal K, Curran D, Groenvold M. the EORTC Quality of Life Group .The EORTC QLQ‐C30 Scoring Manual. 3rd edn. Brussels, Belgium; European Organisation for Research and Treatment of Cancer 2001
• 10 Gitt A K, Wasserman K, Kilkowski C, Kleemann T, Kilkowski A, Bangert M, Schneider S, Schwarz A, Senges J. Exercise anaerobic threshold and ventilatory efficiency identify heart failure patients for high risk of early death.  Circul. 2002;  10 3079-3084
• 11 Gotshalk L A, Volek J S, Staron R S, Denegar C R, Hagerman F C, Kraemer W J. Creatine supplementation improves muscular performance in older men.  Med Sci Sports Exerc. 2002;  34 537-543
• 12 Guralnik J M, Simonsick E M, Ferrucci L, Glynn R J, Berkman L F, Blazer D G, Scherr P A, Wallace R B. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission.  J Geront. 1994;  49 M85-M94
• 13 Herrero F, San Juan A F, Fleck S J, Pérez M, Cañete S, Earnest C P, Foster C, Lucia A. Combined aerobic and resistance training in breast cancer survivors: a randomized, controlled pilot trial.  Int J Sports Med. 2006;  27 573-580
• 14 Hortobagyi T, Houmard J A, Stevenson J R, Fraser D D, Johns R A, Israel R G. The effects of detraining on power athletes.  Med Sci Sports Exerc. 1993;  25 929-935
• 15 Jackson A S, Pollock M L. Practical assessment of body composition.  Phys Sport Med. 1985;  13 79-90
• 16 Kiilavuori K, Sovijarvi A, Naveri H, Ikonen T, Leinonen H. Effect of physical training on exercise capacity and gas exchange in patients with chronic heart failure.  Chest. 1996;  110 985-991
• 17 Klausen K, Andersen L B, Pelle I. Adaptive changes in work capacity, skeletal muscle capillarization and enzyme levels during training and detraining.  Acta Physiol Scand. 1981;  113 9-16
• 18 Kuipers H, Verstappen F T, Keizer H A, Geurten P, van Kranenburg G. Variability of aerobic performance in the laboratory and its physiologic correlates.  Int J Sports Med. 1985;  6 197-201
• 19 Lee R C, Wang Z, Heo M, Ross R, Janssen I, Heymsfield S B. Total-body skeletal muscle mass: development and cross-validation of anthropometric prediction models.  Am J Clin Nutr. 2000;  72 796-803
• 20 Lemmer J T, Hurlbut D E, Martel G F, Tracy B L, Ivey F M, Metter E J, Fozard J L, Fleg J L, Hurley B F. Age and gender responses to strength training and detraining.  Med Sci Sports Exerc. 2000;  32 1505-1512
• 21 Londeree B R. Effect of training on lactate/ventilatory thresholds: a meta-analysis.  Med Sci Sports Exerc. 1997;  29 837-843
• 22 Lucia A, Earnest C, Perez M. Cancer-related fatigue: how can exercise physiology assist oncologists?.  Lancet Oncol. 2003;  4 616-625
• 23 Lucia A, Hoyos J, Santalla A, Earnest C, Chicharro J L. Tour de France versus Vuelta a España: which is harder?.  Med Sci Sports Exerc. 2003;  35 872-878
• 24 Marx J O, Ratamess N A, Nindl B C, Gotshalk L A, Volek J S, Dohi K, Bush J A, Gomez A L, Mazzetti S A, Fleck S J, Hakkinen K, Newton R U, Kraemer W J. Low-volume circuit versus high-volume periodized resistance training in women.  Med Sci Sports Exerc. 2001;  33 635-643
• 25 Mazzetti S A, Kraemer W J, Volek J S, Duncan N D, Tatamess N A, Gomez A L, Newton R U, Hakkinen K, Fleck S J. The influence of direct supervision of resistance training on strength performance.  Med Sci Sports Exerc. 2000;  32 1175-1184
• 26 McKenzie D C, Kalda A L. Effect of upper extremity exercise on secondary lymphedema in breast cancer patients: a pilot study.  J Clin Oncol. 2003;  21 463-466
• 27 Meyer T, Lucia A, Earnest C P, Kindermann W. A conceptual framework for performance diagnosis and training prescription from submaximal parameters - Theory and application.  Int J Sports Med. 2005;  26 (Suppl 1) S38-S48
• 28 Mujika I, Padilla S. Muscular characteristics of detraining in humans.  Med Sci Sports Exerc. 2001;  33 1297-1303
• 29 Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood J E. Exercise capacity and mortality among men referred for exercise testing.  N Engl J Med. 2002;  4 793-801
• 30 Ready A E, Quinney H A. Alterations in anaerobic threshold as the result of endurance training and detraining.  Med Sci Sports Exerc. 1982;  14 292-296
• 31 Segal R J, Reid R D, Courneya K S, Malone S C, Parliament M B, Scott C G, Venner P M, Quinney H A, Jones L W, D'Angelo M E, Wells G A. Resistance exercise in men receiving androgen deprivation therapy for prostate cancer.  J Clin Oncol. 2003;  21 1653-1659
• 32 Wang J S, Jen C J, Chen H I. Effects of chronic exercise and deconditioning on platelet function in women.  J Appl Physiol. 1997;  83 2080-2085