None listed
Conditions
Brief summary
Purpose Appropriate physical exercise has produced meaningful improvements in function and reduction in fatigue for a range of cancer populations but the specifics of prescription are not well established. This study examined the effects of a 12-week high-intensity (HI) versus a low-intensity (LI) resistance training protocol on body composition, lymphatic volume, physical and functional fitness, quality of life (QOL),fatigue and psychosocial functioning in breast cancer patients in Kenya. Patients and methods Seventy-three breast cancer survivors (mean age 53; BMI 28) with unilateral lymphedema were randomly assigned to usual care (n=31), supervised HI resistance exercise (n =31), or supervised LI resistance exercise (n=32). Outcome measures included assessments for body composition; lymphatic relative volume; muscle strength, aerobic fitness; fatigue, symptom experience, and QOL (EORTC-C30 BR-23). Results Analysis of covariance was used to compare outcomes for groups at 12-weeks adjusted for baseline values and potential confounders. Both HI and LI reduced lymphatic relative volume, (HI -8.6%; LI -7.8%, p=.001) and improved muscle strength (chest press: HI +4.7kg; LI +3.8kg; seated row: (HI +9.7kg; LI +4.9kg; leg extension: HI +5.6kg; LI +3.9kg, p=.001). Aerobic fitness measured by the 400-m walk improved for both HI (-36.2 sec, p=.025) and LI (-18.9 sec, p=.004) groups compared to usual care (p<.05). HI was also superior to LI exercise (-16.3 sec, p=.020) on the 400-m walk. General fatigue reduced by -28.2% and -25.3% for HI and LI groups, respectively (p=.001). HI and LI protocols also enhanced body image (HI +20.8%; LI +23.4%, p<05), breast (HI -9.5%; LI -10.8%, p<.05) and arm symptoms (HI -15.2%; LI -13.6%, p<.05). Conclusion We found both exercise protocols effective for improving muscle strength, physical function, lymphatic volume and symptom scales. Further, we have demonstrated for the first time that high-intensity exercise can be well tolerated and should also be considered in this population, not only for effective management of lymphedema but also improvement and preservation of function and quality of life.
Interventions
Arm 1 – High-Intensity Resistance Training
Arm 2 – Low-Intensity Resistance Training
Arm 3 – Usual Care (Control)
Participants undertook combined aerobic and progressive resistance training twice a week for 12-
weeks in a supervised clinical exercise facility. Five minutes warm-up and cool-down were
performed before and after each exercise session and included light aerobic activity and stretching.
The resistance exercises included the chest press, seated row, and lateral pull down, lateral rai
Arm 1 – High-Intensity Resistance Training Arm 2 – Low-Intensity Resistance Training Arm 3 – Usual Care (Control) Participants undertook combined aerobic and progressive resistance training twice a week for 12- weeks in a supervised clinical exercise facility. Five minutes warm-up and cool-down were performed before and after each exercise session and included light aerobic activity and stretching. The resistance exercises included the chest press, seated row, and lateral pull down, lateral raises, front raises, triceps extension, leg extension and abdominal crunches. The resistance exercise program was designed to progress from 8- to 5-repetition maximum (RM) for two to four sets per exercise for the HI group, whilst the LI exercise group progressed from 18- to 15-RM using two to four sets per exercise. The aerobic component of the training program included 15 to 25 minutes of cardiovascular exercises (walking/cycling/jogging) at 65% to 80% maximum heart rate and at a perceived exertion ranging from 11 to 13 (6 to 20 point Borg Scale). Sessions were conducted in small groups of 4-8 participants under direct supervision of an exercise physiologist and lasted approximately 50-minutes. Patients were encouraged to maintain customary diet intake throughout the study. The study was confined to the two training locations in Nairobi.
Sponsors
Edith Cowan University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
History of non-metastatic unilateral breast cancer Completion of Treatment (radiotherapy and/or chemotherapy) at least 6-weeks prior to study Secondary lymphedema Not participated in structured exercise training in last 3-months
Exclusion criteria
Any musculoskeletal, cardiovascular, neurological or psychiatric condition that could be exacerbated by exercise or not otherwise approved by their oncologist
Outcome results
None listed