Personalized home-based interval exercise training may improve cardiorespiratory fitness in cancer patients preparing to undergo hematopoietic cell transplantation

Abstract

Impaired cardiorespiratory fitness is associated with inferior survival in patients preparing to undergo hematopoietic cell transplantation (HCT). Exercise training based on short, higher-intensity intervals has the potential to efficiently improve cardiorespiratory fitness. We studied home-based interval exercise training (IET) in 40 patients prior to autologous (N=20) or allogeneic (N=20) HCT. Each session consisted of 5, three-minute intervals of walking, jogging, or cycling at 65-95% maximal heart rate (MHR) with 3 minutes of low intensity exercise (<65% MHR) between intervals. Participants were asked to perform sessions at least 3 times weekly. The duration of the intervention was at least 6 weeks, depending on each patient’s scheduled transplantation date. Cardiorespiratory fitness was assessed from a peak oxygen consumption test (VO2peak) and a 6 minute walk (6MWD) before and after the intervention period. For the autologous HCT cohort, improvements in VO2peak (p=0.12) and 6MWD (p=0.19) were not statistically significant. For the allogeneic cohort, the median VO2peak improvement was 3.7ml/kg*min (p=0.005) and the median 6MWD improvement was 34 meters (p=0.006). Home-based, interval exercise training can be performed prior to HCT and has the potential to improve cardiorespiratory fitness.

Mobilization and Exercise Intervention for Patients With Multiple Myeloma: Clinical Practice Guidelines Endorsed by the Canadian Physiotherapy Association

“…Exercise for patients with MM may be important and beneficial before, during, and after medical treatment given that exercise, for those with and without cancer, can reduce fatigue and muscle wasting and increase QOL. 3 , 6 The first phase (peri-transplant) may be an opportunistic period before deconditioning as the benefits of increased fitness may reduce treatment-related recovery time , 23 creating a platform for better sleep, less fatigue, and better QOL. Unfortunately, limited research is available during this phase.…”

“…Unfortunately, limited research is available during this phase. 23 , 24 The next phase of the treatment pathway is medical therapy, another critical period for patients with MM both for combating the disease symptoms as well as treatment-related symptoms (poor sleep, increased fatigue, and physical/mental health declines). 3–6 A limited number of research articles report on exercise programs for patients with MM during treatment.…”

“…The research for patients with MM in this phase is limited, but the results suggest that it is safe and feasible as an unsupervised program; however, compliance with strength training was minimal. 23 , 24 Aerobic training in the form of walking may be the preferred modality yet may not provide enough benefit, compared with resistance and high-intensity training, for these patients. 24 More research is required in this phase to understand the impact of exercise in the later stages of the treatment pathway.…”

Hoch-intensives Intervalltraining in der onkologischen Rehabilitation – Erfahrungen aus der Therapiepraxis

“…Das Fazit der vorhandenen Literatur: Hoch-intensives Intervalltraining kann sowohl während der adjuvanten Therapie als auch in der anschließenden onkologischen Rehabilitation angewandt werden [8][9][10][11][12][13][14][15][16][17][18][19]. Für die bisher publizierten Studien zu dieser Thematik haben insgesamt 702 Menschen mit unterschiedlichen Tumorerkrankungen und in verschiedenen Therapiestadien trainiert [8][9][10][11][12][13][14][15][16][17][18][19] Keine KG = Kontrollgruppe, HRmax = maximale Herzfrequenz, HR peak = peak Herzfrequenz, HRR = Herzfrequenzreserve, VO2 peak = peak Sauerstoffaufnahme, WR peak = peak work rate persönlicher Vorliebe ihre Berechtigung. Wünschenswert wäre es, das Training auch in der Rehabilitation individueller an die unterschiedlichen Fähigkeiten und Bedürfnisse der Patienten anpassen zu können.…”

“…Dieses konnte allerdings nicht auf das hochintensive Training zurückgeführt werden. In der Studie von Adamsen et al erlitt 1 Patient mit Gehirntumor einen epileptischen Anfall nach der Intervention, weshalb die Autoren bei dieser Tumorart von HIIT abraten[10].Mit Blick auf die bisherige Forschung zeigt sich das Hochintensive Intervalltraining als eine gut umsetzbare und sichere Trainingsmethode nach Krebs[8][9][10][11][12][13][14][15][16][17][18][19].…”