Two-year follow-up of the OptiTrain randomised controlled exercise trial

Bolam, Kate A.; Mijwel, Sara; Rundqvist, Helene; Wengström, Yvonne

doi:10.1007/s10549-019-05204-0

Cited by 51 publications

(96 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similar to the previously reported intention to treat analyses of this OptiTrain study, there was no betweengroups difference in VO 2peak at the 1-and 2-year follow up time points (supplementary Fig. 2A-C) [31,32].…”

Section: Cardiorespiratory Fitnesssupporting

confidence: 86%

“…The participants were randomly allocated to resistance and high-intensity interval training (RT-HIIT), moderate-intensity aerobic and high-intensity aerobic interval training (AT-HIIT), or usual care (UC). The original OptiTrain RCT protocol and intention to treat analyses of the 16-week, 1 and 2-year-follow-up have been published [19,[30][31][32][33][34]. In the current study we used a per protocol analysis.…”

Section: Methodsmentioning

confidence: 99%

“…Outcomes were assessed at baseline and after the intervention period (16-weeks), and at one, two and 5 years (5 year-assessments are currently ongoing and not included in this study) post-baseline. Objectively measured sedentary behaviour and physical activity were assessed by accelerometer (model GT3X ActiGraph) at baseline and estimated VO 2peak , as a proxy for cardiorespiratory fitness (CRF), was assessed at baseline and at all follow up timepoints using the Åstrand Rhyming submaximal cycle test as previously described [31]. VO 2peak is presented in the study expressed as litres per min (l/min) to avoid the impact of body mass fluctuations.…”

Section: Outcome Measuresmentioning

confidence: 99%

See 2 more Smart Citations

High intensity exercise during breast cancer chemotherapy - effects on long-term myocardial damage and physical capacity - data from the OptiTrain RCT

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background Adjuvant systemic breast cancer treatment improves disease specific outcomes, but also presents with cardiac toxicity. In this post-hoc exploratory analysis of the OptiTrain trial, the effects of exercise on cardiotoxicity were monitored by assessing fitness and biomarkers over the intervention and into survivorship. Methods; Women starting chemotherapy were randomized to 16-weeks of resistance and high-intensity interval training (RT-HIIT), moderate-intensity aerobic and high-intensity interval training (AT–HIIT), or usual care (UC). Outcome measures included plasma troponin-T (cTnT), Nt-pro-BNP and peak oxygen uptake (VO2peak), assessed at baseline, post-intervention, and at 1- and 2-years. Results For this per-protocol analysis, 88 women met criteria for inclusion. Plasma cTnT increased in all groups post-intervention. At the 1-year follow-up, Nt-pro-BNP was lower in the exercise groups compared to UC. At 2-years there was a drop in VO2peak for patients with high cTnT and Nt-pro-BNP. Fewer patients in the RT-HIIT group fulfilled biomarker risk criteria compared to UC (OR 0.200; 95% CI = 0.055–0.734). Conclusions In this cohort, high-intensity exercise was associated with lower levels of NT-proBNP 1-year post-baseline, but not with cTnT directly after treatment completion. This may, together with the preserved VO2peak in patients with low levels of biomarkers, indicate a long-term cardioprotective effect of exercise. Trial registration Clinicaltrials.govNCT02522260, Registered 13th of august 2015 – Retrospectively Registered Graphical abstract

show abstract

Section: Cardiorespiratory Fitnesssupporting

confidence: 86%

Section: Methodsmentioning

confidence: 99%

Section: Outcome Measuresmentioning

confidence: 99%

See 1 more Smart Citation

High intensity exercise during breast cancer chemotherapy - effects on long-term myocardial damage and physical capacity - data from the OptiTrain RCT

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Generally, the RT‐HIIT intervention had larger effect sizes on patient‐reported symptoms, especially multidimensional cancer‐related fatigue and preservation of cognitive functioning compared with the AT‐HIIT group . These positive effects on total symptoms, cancer‐related fatigue and strength persisted at 1 and 2 years after chemotherapy relative to the usual care group despite no current differences between groups in objectively measured physical activity . Taken together, these results demonstrate that the combination of aerobic interval training and resistance training twice per week for 16 weeks throughout chemotherapy treatment improves the patient experience of chemotherapy, prevents negative physiological sequelae of chemotherapy, and improves long‐term patient well‐being.…”

mentioning

confidence: 70%

Supervised, Multimodal Exercise: The Chemotherapy Supportive Therapy That Almost Does It All

Kirkham

2019

The Oncologist

View full text Add to dashboard Cite

Delivery of full chemotherapy dose intensity with minimization of adverse chemotherapy-related events is a primary quality of care indicator in medical oncology. Clinical oncology professionals are also increasingly recognizing patient quality of life as a vital component of cancer care [1]. As such, a therapy that could maximize delivery of chemotherapy relative dose intensity (RDI), reduce treatment toxicities, and improve quality of life, with positive side effects of improved physical fitness, reduced anxiety and depression, and extended overall survival, would likely be prescribed by every medical oncologist in every cancer treatment center. Although such a therapy does not currently exist, Mijwel et al. report on a therapy that comes close in this issue of The Oncologist [2].In this article, Mijwel et al. report results of the OptiTrain trial, a 3-arm randomized trial of two different exercise interventions versus usual care, on rates of chemotherapy completion, hospitalization, and hematological toxicity [2]. The trial compared 16 weeks of high-intensity aerobic interval training (three sets of 3 minutes with 1-minute recovery) combined with either resistance training (RT-HIIT) or moderate-intensity aerobic training (AT-HIIT) to usual cancer care. Although this may sound challenging for patients, the exercise sessions took place only twice per week for 60 minutes and were closely supervised in an in-hospital exercise clinic. Patients in the exercise programs, many of whom had comorbid conditions, attended approximately two thirds of offered exercise sessions throughout chemotherapy and were typically able to complete the exercise prescription at the sessions they attended.One of the most compelling clinical outcomes of exercise for oncology care providers is thought to be the potential for exercise interventions to enhance patient tolerance of chemotherapy and thereby delivery of the planned RDI [3]. Although the rationale for exercise training-related improvement of RDI is robust (preservation of muscle mass and physical function should enhance tolerance), the current research evidence is not. A recent systematic review reported that none of the eight randomized exercise trials that have evaluated RDI have reported clinically relevant effects, although two had statistically significant effects [4]. In line with these results, the high-quality, multimodal OptiTrain interventions did not have an impact on RDI, despite the RT-HIIT intervention achieving the proposed biologic mechanism of enhanced muscle mass, strength, and physical fitness. There was no difference between either exercise group and usual care in achieved RDI, prevalence of a single dose reduction, or percentage of participants receiving ≥85% of RDI [2]. Receipt of >85% of RDI is a known threshold for achievement of chemotherapy effectiveness [5]. Notably, although approximately one quarter of all patients in the OptiTrain trial required at least one single chemotherapy dose reduction, the majority (83%) still received >85% RDI, likely thanks ...

show abstract

“…However, the little data that are available regarding muscle strength in advanced BC patients or at risk of cachexia, for instance, have proven the maximum effects in improving muscle strength while reducing inflammation and fatigue [ 201 ]. RT-HIIT was shown to be an effective combination program to increase muscle strength and decrease fatigue in a cohort group of 206 women with BC, in comparison to those receiving usual care [ 202 ]. Multimodal exercise interventions including AT, RT, and stretching training are also associated with improvements in cancer-related fatigue [ 203 ].…”

Section: Pa In Bc Managementmentioning

confidence: 99%

Physical Activity as an Imperative Support in Breast Cancer Management

Ortega

Fraile-Martínez

García-Montero

et al. 2020

Cancers

View full text Add to dashboard Cite

Breast cancer (BC) is the most common malignancy and the second cause of cancer-related death among women. It is estimated that 9 in 10 cases of BC are due to non-genetic factors, and approximately 25% to 30% of total breast cancer cases should be preventable only by lifestyle interventions. In this context, physical activity represents an excellent and accessible approach not only for the prevention, but also for being a potential support in the management of breast cancer. The present review will collect the current knowledge of physical activity in the background of breast cancer, exploring its systemic and molecular effects, considering important variables in the training of these women and the evidence regarding the benefits of exercise on breast cancer survival and prognosis. We will also summarize the various effects of physical activity as a co-adjuvant therapy in women receiving different treatments to deal with its adverse effects. Finally, we will reveal the impact of physical activity in the enhancement of quality of life of these patients, to conclude the central role that exercise must occupy in breast cancer management, in an adequate context of a healthy lifestyle.

show abstract

Two-year follow-up of the OptiTrain randomised controlled exercise trial

Cited by 51 publications

References 27 publications

High intensity exercise during breast cancer chemotherapy - effects on long-term myocardial damage and physical capacity - data from the OptiTrain RCT

High intensity exercise during breast cancer chemotherapy - effects on long-term myocardial damage and physical capacity - data from the OptiTrain RCT

Supervised, Multimodal Exercise: The Chemotherapy Supportive Therapy That Almost Does It All

Physical Activity as an Imperative Support in Breast Cancer Management

Contact Info

Product

Resources

About