ECSS Paris 2023: OP-MH20
INTRODUCTION: There were ~2.3 million cases of female breast cancer diagnosed worldwide in 2022 (1). Exercise training has a positive effect on survival, disease recurrence and all-cause mortality. Barriers that hinder employing supervised exercise programmes in oncology settings, include staff training and capacity, resources and facilities, accessibility and costs. Remotely-supported exercise training is an alternative that can bring about beneficial health effects. This randomised, controlled non-inferiority trial investigated whether 8 weeks of remotely-supported exercise training changes cardiorespiratory fitness, functional fitness and body composition by a magnitude that is not meaningfully inferior to changes caused by partly-supervised exercise training among female breast cancer survivors. METHODS: After randomisation, n=30 (57 ± 6 years, V̇O2max 28.9 ± 6.1 ml·kg-1·min-1, BMI 25.3 ± 3.3 kg·m-2) female breast cancer survivors completed 8 weeks of partly-supervised (n=15) or remotely-supported (n=15) exercise training. The partly-supervised group undertook two supervised and one unsupervised session per week progressing from 55-70% V̇O2max and 35-50 min. The remotely-supported group were prescribed the same total duration of exercise per week progressing from 105-150 min. Intensity was prescribed using heart rate targets corresponding to 55-70% V̇O2max. V̇O2max, functional fitness measurements, body composition (via dual-energy x-ray absorptiometry) and blood pressure was assessed pre- and post-intervention. RESULTS: Adherence was higher in the partly-supervised group (87 ± 7%) compared to the remotely-supported group (64 ± 25%; p=0.01). The remotely-supported group exhibited changes in one functional fitness measurement (timed up and go, difference to partly-supervised; 95% CI −0.8 to 0.4 s) and one measure of body composition (percentage body fat, difference to partly-supervised; 95%CI −0.6 to 0.5 kg·m-2) that were non-inferior in magnitude to the partly-supervised group. It was inconclusive whether changes among the remotely-supported group for V̇O2 max (difference to partly-supervised; 95% CI −3.3 to 1.1 ml·kg-1·min-1), blood pressure (difference to partly-supervised; 95% CI systolic; −3 to 12 mmHg, diastolic; −5 to 6 mmHg), 6 minute walk (difference to partly-supervised; 95% CI −54.0 to 0.4 m), or sit to stand (difference to partly-supervised; 95% CI −3 to 2 repetitions), were non-inferior in magnitude compared to the partly-supervised group. CONCLUSION: 8 weeks of remotely-supported exercise may be an alternative to 8 weeks of partly-supervised exercise for influencing functional fitness (assessed by timed up and go) and percentage body fat. It remains inconclusive whether remotely-supported exercise is an alternative to 8 weeks of partly-supervised exercise for influencing cardiorespiratory fitness, functional fitness (assessed by 6-minute walk, sit to stand) and blood pressure. References 1. Bray F, et al. Global cancer statistics 2022
Read CV Lauren STRUSZCZAKECSS Paris 2023: OP-MH20
INTRODUCTION: In women with breast cancer, the most common complications after surgery include the development of lymphedema and a reduction in mobility and strength in the operated limb, leading to a negative impact on psychological well-being1. Studies suggest that rowing or an adapted physical activity (APA) program may be a viable strategy to mitigate the negative effects of breast cancer and its treatment2,3. The purpose of the study was to examine the effects of rowing on arm lymphedema, mobility, strength and psychological well-being in breast cancer survivors participating in a 6-month APA program. METHODS: The project Effect and efficacy of RowIng in breast CancEr survivors (ERICE) involved 27 women with breast cancer (age: 56.6±6.5 yrs; BMI: 23.9±3.0 kg/m2; stages I, II, or III; surgery at least 6 months to a maximum of 20 years ago), who trained 3 times a week for 6 months with sculling (a form of sliding-seat rowing moving the boat with two oars per rower), online APA sessions and walking. The analysis conducted at baseline (T0) and at the end of the training program (T1) included arm lymphedema (Arm Volume_AV), mobility (Back Scratch_BS) and strength (Hand Grip_HG) evaluation. Additionally, Functional Assessment of Cancer Therapy – Lymphedema (FACT-B+4) and Rosenberg Self-Esteem Scale (RSES, Italian version) were administered. A minimum adherence of 75% to the program was required. RESULTS: During the 6-month intervention, 19 women completed the program and 13 of them achieved the required adherence (N: 6_NAD vs N: 13_AD). No variation in AV of both operated (OA) and non-operated (NOA) arms was observed (OA: T0, 1566.7±274.6 vs T1, 1567.8±279.3; NOA: T0, 1513.1±254.3 vs T1, 1557.5±265.4 cm3). Despite this, an improvement in both operated and non-operated arms BS (OA: T0, 2.0±7.6 vs T1, 3.0±7.8; NOA: T0, 3.3±7.3 vs T1, 4.1±7.2 cm) was noticed, with a greater improvement in HG performance in women who achieved the required adherence (OA: ∆AD, 1.2±2.4 vs ∆NAD, -3±1.4 kg, p=0.0029; NOA: ∆AD, 1±1.7 vs ∆NAD, -2.6±2.2 kg, p=0.0044). Psychological well-being (FACT-B+4: T0, 123.0±15.1 vs T1, 122.3±14.8 score) and self-esteem (RSES: T0, 20.0±5.1 vs T1, 20.74±5.87 score) remained stable. CONCLUSION: An APA program combined with sculling revealed to have a positive impact on flexibility and strength. It is important to emphasize that improvements in physical parameters were observed only among participants achieving at least 75% of adherence. References: 1Lovelace DL. 2019 Nov;64(6):713-724. 2Xu Q. 2024 Aug 31;13(8):1494-1510. 3Real-Pérez M. 2025 Jan 22;20(1).
Read CV Giacomo NucciECSS Paris 2023: OP-MH20
INTRODUCTION: Physical exercise during treatment may counteract some of the adverse effects following (neo-)adjuvant chemotherapy for breast cancer. However, the optimal exercise intensity and whether the benefits of exercise during chemotherapy continue into survivorship is not well-known (1,2). The aim of the current study was to examine the effects of high (HIT) vs. moderate (MIT) intensity exercise during chemotherapy on cardiorespiratory fitness, muscular endurance, body composition and muscle strength in patients with breast cancer 12 months following completion of chemotherapy. METHODS: Women diagnosed with stage I-III breast cancer (n=80) was randomized to either a HIT or MIT training group. Both groups performed home-based endurance training and supervised strength training twice a week over the course of chemotherapy (approximately 12-24 weeks) at an intensity of 80-90% of heart rate reserve (HRR) and 1RM (HIT) or 40-50% of HRR and 1RM (MIT). Measures of VO2max, muscle strength, body composition and muscular endurance were performed before (T0), immediately after (T1) and 12 months after the completion of chemotherapy and training (T2). In total, 55 participants (HIT, n=26, MIT, n=29) completed follow up measures. RESULTS: VO2max decreased in both groups during chemotherapy (T0-T1, HIT: -19%, p<0.01, MIT: -14%, p<0.01), but were not different from baseline values 12 months later (T0-T2) HIT: -4%, p=0.07 MIT: -3%, p=0.80). There was no significant difference between the groups. HIT increased chest press strength at T1 (8%, p=0.03) and tended to have an increase at T2 (7%, p=0.06). There was no change in the MIT group (T1: 4%, p=0.24, T2: 5%, p=0.27) and no significant difference between the groups. Leg press strength increased in HIT at T1 by 5% (p<0.05) and at T2 by 32% (p<0.01) and in MIT at T2 by 13% (p=0.03) but not at T1 (0%, p=0.93). There was a significant difference between the groups at T2 (p=0.04) but not at T1. Leg extension strength increased in the HIT group at T2 (11%, p=0.04) but not at T1 (1%, p=1.00). There was no change in the MIT group (T1: -1%, p=0.39, T2: 6%, p=0.43) and no significant difference between the groups. Muscular endurance did not change in either group. Lean body mass increased in both groups at T1 (HIT: 2%, p<0.01, MIT: 3%, p<0.01) but not at T2 (HIT: 0%, p=0.91, MIT: 0%, p=0.23). There was no significant difference between the groups. Fat mass increased in the HIT group at both T1 (4%, p<0.05) and T2 (10% (p<0.01) with no change in the MIT group (T1: 2%, p=0.92, T2: 4% (p=0.14). CONCLUSION: Both high and moderate intensity exercise was effective in preserving cardiorespiratory fitness 12 months after completion of chemotherapy for breast cancer, but HIT improved muscle strength more than MIT. References 1.Furmaniak et al., Cochrane Database of Systematic Reviews; 2016; 9:1465-1858 2.Mijwel et al., Breast Cancer Res. Treat. 2018; 169:93–103.
Read CV Tor Helge WiestadECSS Paris 2023: OP-MH20