Comparison of physiological response to cardiopulmonary exercise testing among cancer survivors and healthy controls

Abstract

Selected physiological responses, including lactate kinetics, to cardiopulmonary exercise testing (CPET) were evaluated among a group of cancer survivors (CS, n = 55) and healthy controls (HC, n = 213). It was uncertain if lactate testing in a group of cancer survivors could provide useful information about training intensity. It was hypothesized that chemotherapy, radiation, surgery, physical inactivity or some combination thereof would alter the normal lactate kinetics (curvilinearity) in the relationship of lactate concentration versus power. Physiologic responses of CS (heart rate, blood pressure, O(2) saturation, RPE, lactate, VO(2peak), and peak power) during cycle ergometry were compared to HC. Comparisons (t tests and Chi-square) were made between the groups and shape of lactate plots were analyzed for determination of a breakpoint. Multiple logistical regressions were then utilized to identify factors related to the inability to determine lactate breakpoints. Lactate breakpoints were common to all but one HC whereas among the CS there was a small subset of subjects (n = 5) who did not show a lactate breakpoint. Group differences indicated that female CS were significantly older, had greater BMI's, and lower work capacity than HC. Males CS had significantly lower work capacity than HC. Multiple logistical regression analyses, in all instances, yielded no statistically significant models predictive of the inability to determine a lactate breakpoint. In this sample of CS and HC, physiological responses and lactate kinetics during CPET were similar while work capacity among the CS was lower. Because lactate breakpoints were found, lactate threshold could be determined for all but a few individuals. For those working with CS, CPET with ECG monitoring and lactate threshold measures should be considered for those wishing for precise and safe training intensities.

Changes in exercise capacity, quality of life and fatigue in cancer patients during an intervention

“…Thereby, IAT, shown to be helpful in establishing training intensities in cancer populations (Klika et al . , ), was defined as the workload corresponding to a lactic acid concentration at the aerobic threshold plus 1.5 mmol/l, according to Dickhuth et al . ().…”

“…Aerobic exercise capacity was determined by a physiciansupervised cardiopulmonary exercise test (CPET), a safe and effective method to assess functional capacity in cancer patients (Klika et al 2009(Klika et al , 2011. Participants were asked to refrain from alcohol or caffeine use and strenuous physical activity for 24 h, from light physical activity for 4 h, and from eating 2 h before CPET.…”

“…According to validated general lactate threshold assumptions (Faude et al 2009) moderate exercise intensity was 70-90% of individual anaerobic threshold (IAT) derived from the CPET and RPE (rates of perceived exertion) target score of 13-14 on the Borg (6-20) scale. Thereby, IAT, shown to be helpful in establishing training intensities in cancer populations (Klika et al 2009(Klika et al , 2011, was defined as the workload corresponding to a lactic acid concentration at the aerobic threshold plus 1.5 mmol/l, according to Dickhuth et al (1999). Additionally, the opportunity to participate in a supervised exercise programme consisting of a 60-min Nordic Walking training session once a week was given.…”

The Impact of Prehabilitation on Patient Outcomes in Hepatobiliary, Colorectal, and Upper Gastrointestinal Cancer Surgery

“…Due to the variability in exercise types, frequency, and duration it was not possible to group cancer types together to arrive at a combined effect for functional capacity. This is pertinent in cases where physiological/biological differences may affect the response to prehabilitation strategies 51,52 as well as the effect of neoadjuvant chemotherapy, 53 long/short course chemoradiation, 54 and preoperative jaundice. 55 Prehabilitation interventions spanned from as little as 1 week 44 to a maximum of 6 weeks.…”

Acute Physiological Responses Following a Bout of Vigorous Exercise in Military Soldiers and First Responders with PTSD: An Exploratory Pilot Study

“…Prior to commencement, participants were given an explanation of the Borg Rate of Perceived Exertion Scale (6-20 RPE scale). The protocol, adapted from Klika et al [35], started at 50 W and increase by 50 W every two minutes. Participants provided their RPE at the end of each stage (every two minutes).…”