Introduction
Methods
Participants and procedures
Exercise training interventions
Motivational seminars and exercise sessions to maintain physical exercise adherence
Statistical analysis
RT-HIIT n = 74 | AT-HIIT n = 72 | UC n = 60 | ||
---|---|---|---|---|
Mean ± SD | Mean ± SD | Mean ± SD | p value* | |
Age (years) | 52.7 ± 10.3 | 54.4 ± 10.3 | 52.6 ± 10.2 | 0.89 |
Body mass (kg) | 68.7 ± 11.3 | 67.7 ± 13.0 | 69.1 ± 11.0 | 0.37 |
Height (cm) | 165.7 ± 6.7 | 165.3 ± 6.6 | 166.4 ± 7.0 | 0.76 |
SED (% of daily wear time) | 63.7 ± 7.7 | 65.6 ± 6.2 | 66.6 ± 7.2 | 0.28 |
MVPA (% of daily wear time) | 9.6 ± 2.8 | 8.3 ± 2.8 | 8.5 ± 4.3 | 0.14 |
% | % | % | p value† | |
Married or partnered | 60.6 | 59.7 | 69.5 | 0.81 |
University completed | 67.6 | 64.7 | 66.0 | 1.00 |
Postmenopausal women | 51.4 | 63.9 | 61.7 | 0.39 |
Tumor receptor status | 0.15 | |||
Triple negative | 14.9 | 11.0 | 16.7 | |
HER2+, ER± | 21.6 | 30.2 | 20.0 | |
HER2−, ER+ | 62.2 | 58.9 | 61.6 | |
HER2−, ER− | 1.4 | 0.0 | 1.7 | |
Hormone therapy | 85.7 | 84.4 | 70.5 | 0.40 |
Chemotherapy received at baseline | 0.98 | |||
Taxane-based therapy | 40.6 | 37.0 | 41.7 | |
Anthracycline-based therapy | 59.4 | 63.0 | 58.3 |
Adjusted group differences in mean change from baseline to 12 months (95% CI) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
Baseline | 16 weeks | 12 months | Mean change | Lower bound 95% CI | Upper bound 95% CI | p value | ES | |||
PFS questionnaire | Mean ± SD | Mean ± SD | Mean ± SD | |||||||
Behavior/daily life CRF | RT-HIIT | 3.10 ± 3.39ɸ | 3.01 ± 3.31 | 2.34 ± 2.68 | RT-HIIT vs UC | − 1.65 | − 2.71 | − 0.59 |
0.001
| − 0.76 |
AT-HIIT | 1.87 ± 2.57 | 2.98 ± 2.89 | 2.16 ± 2.52 | AT-HIIT vs UC | − 1.29 | − 2.36 | − 0.23 |
0.011
| − 0.50 | |
UC | 2.04 ± 2.79 | 4.02 ± 3.29 | 3.48 ± 3.13 | |||||||
Emotional/affective CRF | RT-HIIT | 3.28 ± 3.43 | 3.45 ± 3.33 | 3.12 ± 2.89 | RT-HIIT vs UC | − 1.35 | − 2.51 | − 0.19 |
0.017
| − 0.60 |
AT-HIIT | 2.37 ± 2.98 | 3.74 ± 3.23 | 3.02 ± 2.96 | AT-HIIT vs UC | − 1.19 | − 2.36 | − 0.02 |
0.045
| − 0.39 | |
UC | 2.45 ± 3.01 | 4.24 ± 3.22 | 4.10 ± 3.15 | |||||||
Sensory/physical CRF | RT-HIIT | 3.24 ± 3.23 | 3.27 ± 3.19 | 3.04 ± 2.83 | RT-HIIT vs UC | − 1.05 | − 2.12 | 0.03 | 0.061 | − 0.46 |
AT-HIIT | 2.27 ± 2.87 | 3.53 ± 3.15 | 2.88 ± 2.83 | AT-HIIT vs UC | − 0.88 | − 1.96 | 0.20 | 0.154 | − 0.24 | |
UC | 2.64 ± 3.15 | 4.29 ± 3.31 | 3.82 ± 3.07 | |||||||
Cognitive CRF | RT-HIIT | 2.79 ± 2.95 | 2.82 ± 2.84 | 2.77 ± 2.78 | RT-HIIT vs UC | − 0.88 | − 1.94 | 0.18 | 0.141 | − 0.23 |
AT-HIIT | 1.88 ± 2.51 | 2.61 ± 2.39 | 2.24 ± 2.29 | AT-HIIT vs UC | − 1.17 | − 2.24 | − 0.10 |
0.028
| − 0.13 | |
UC | 2.15 ± 2.70 | 3.47 ± 2.87 | 3.41 ± 2.90 | |||||||
Total CRF | RT-HIIT | 3.09 ± 3.17 | 3.12 ± 3.03 | 2.80 ± 2.64 | RT-HIIT vs UC | − 1.23 | − 2.25 | − 0.21 |
0.012
| − 0.34 |
AT-HIIT | 2.10 ± 2.63 | 3.18 ± 2.77 | 2.58 ± 2.55 | AT-HIIT vs UC | − 1.11 | − 2.14 | − 0.09 |
0.029
| − 0.10 | |
UC | 2.30 ± 2.81 | 3.98 ± 3.05 | 3.68 ± 2.94 |
Adjusted group differences in mean change from baseline to 12 months (95% CI)* | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
Baseline | 16 weeks | 12 months | Mean change | Lower bound 95% CI | Upper bound 95% CI | p value | ES | |||
EORTC-QLQ-C30 questionnaire | Mean ± SD | Mean ± SD | Mean ± SD | |||||||
Global/quality of life | RT-HIIT | 63.56 ± 24.97 | 63.85 ± 19.88 | 73.41 ± 20.57 | RT-HIIT vs UC | 3.56 | − 3.81 | 10.93 | 0.734 | 0.30 |
AT-HIIT | 66.67 ± 20.90 | 63.75 ± 20.29 | 77.12 ± 13.54 | AT-HIIT vs UC | 6.11 | − 1.30 | 13.52 | 0.143 | 0.36 | |
UC | 68.84 ± 21.66 | 59.52 ± 19.62 | 71.72 ± 19.84 | |||||||
Physical functioning | RT-HIIT | 89.38 ± 14.67 | 85.88 ± 16.31 | 91.58 ± 13.77 | RT-HIIT vs UC | 3.68 | − 2.13 | 9.49 | 0.383 | 0.26 |
AT-HIIT | 89.98 ± 11.42 | 85.86 ± 15.37 | 91.87 ± 13.55 | AT-HIIT vs UC | 4.24 | − 1.59 | 10.06 | 0.241 | 0.27 | |
UC | 88.25 ± 16.58 | 76.91 ± 20.22 | 86.40 ± 15.84 | |||||||
Emotional functioning | RT-HIIT | 67.85 ± 25.80 | 72.30 ± 22.92 | 75.00 ± 26.14 | RT-HIIT vs UC | 4.57 | − 3.77 | 12.91 | 0.562 | 0.35 |
AT-HIIT | 74.42 ± 18.94 | 79.86 ± 16.19 | 81.40 ± 16.49 | AT-HIIT vs UC | 9.10 | 0.71 | 17.50 |
0.029
| 0.40 | |
UC | 74.47 ± 24.32 | 69.35 ± 26.26 | 72.79 ± 26.41 | |||||||
Role functioning | RT-HIIT | 59.91 ± 34.72 | 70.83 ± 28.27 | 85.49 ± 22.07 | RT-HIIT vs UC | 7.55 | − 2.01 | 17.10 | 0.173 | 0.46 |
AT-HIIT | 67.61 ± 30.55 | 71.39 ± 26.59 | 88.34 ± 18.98 | AT-HIIT vs UC | 10.00 | 0.46 | 19.53 |
0.036
| 0.33 | |
UC | 69.76 ± 28.07 | 54.46 ± 34.16 | 80.81 ± 26.83 | |||||||
Cognitive functioning | RT-HIIT | 77.00 ± 26.05 | 78.19 ± 20.82 | 77.51 ± 27.95 | RT-HIIT vs UC | 3.47 | − 5.45 | 12.39 | 1.000 | 0.23 |
AT-HIIT | 81.39 ± 20.60 | 79.72 ± 19.91 | 82.78 ± 18.90 | AT-HIIT vs UC | 7.30 | − 1.69 | 16.28 | 0.153 | 0.30 | |
UC | 78.78 ± 25.09 | 69.94 ± 27.42 | 73.28 ± 26.01 | |||||||
Social functioning | RT-HIIT | 64.98 ± 29.91 | 61.76 ± 48.79 | 81.22 ± 25.31 | RT-HIIT vs UC | 1.36 | − 7.84 | 10.56 | 1.000 | 0.19 |
AT-HIIT | 72.91 ± 24.26 | 72.78 ± 24.92 | 89.45 ± 16.79 | AT-HIIT vs UC | 6.19 | − 3.06 | 15.44 | 0.322 | 0.22 | |
UC | 71.65 ± 29.63 | 62.20 ± 28.34 | 82.38 ± 26.64 | |||||||
Fatigue | RT-HIIT | 39.74 ± 29.88 | 37.58 ± 24.51 | 25.22 ± 22.86 | RT-HIIT vs UC | − 7.39 | − 16.99 | 2.21 | 0.194 | − 0.44 |
AT-HIIT | 35.54 ± 23.28 | 38.52 ± 24.84 | 23.71 ± 20.63 | AT-HIIT vs UC | − 9.98 | − 19.66 | − 0.30 |
0.041
| − 0.40 | |
UC | 34.08 ± 25.37 | 48.81 ± 25.58 | 31.87 ± 25.61 | |||||||
Nausea and vomiting | RT-HIIT | 12.87 ± 16.37 | 5.15 ± 10.49 | 2.38 ± 11.14 | RT-HIIT vs UC | − 3.93 | − 9.23 | 1.38 | 0.227 | − 0.47 |
AT-HIIT | 12.99 ± 18.15 | 5.83 ± 12.21 | 2.50 ± 6.74 | AT-HIIT vs UC | − 3.86 | − 9.20 | 1.48 | 0.247 | − 0.45 | |
UC | 8.27 ± 17.16 | 8.04 ± 21.08 | 5.67 ± 16.00 | |||||||
Pain | RT-HIIT | 21.62 ± 24.82 | 21.32 ± 25.08 | 19.58 ± 24.60 | RT-HIIT vs UC | − 6.39 | − 16.46 | 3.67 | 0.379 | − 0.29 |
AT-HIIT | 15.48 ± 22.40 | 16.95 ± 20.47 | 13.88 ± 19.68 | AT-HIIT vs UC | − 9.23 | − 19.36 | 0.89 | 0.086 | − 0.29 | |
UC | 17.32 ± 26.24 | 27.38 ± 29.89 | 22.65 ± 28.32 | |||||||
Dyspnoea | RT-HIIT | 25.11 ± 27.52 | 35.29 ± 29.86 | 20.43 ± 25.86 | RT-HIIT vs UC | − 2.52 | − 13.63 | 8.58 | 1.000 | − 0.08 |
AT-HIIT | 22.25 ± 22.46 | 37.22 ± 28.19 | 19.42 ± 24.76 | AT-HIIT vs UC | − 4.21 | − 15.40 | 6.98 | 1.000 | 0.01 | |
UC | 28.45 ± 25.70 | 44.05 ± 29.89 | 25.77 ± 24.14 | |||||||
Insomnia | RT-HIIT | 37.06 ± 30.00 | 31.37 ± 31.48 | 33.33 ± 31.68 | RT-HIIT vs UC | 3.01 | − 9.90 | 15.92 | 1.000 | 0.04 |
AT-HIIT | 31.85 ± 25.58 | 26.11 ± 30.74 | 26.67 ± 26.62 | AT-HIIT vs UC | − 1.38 | − 14.38 | 11.61 | 1.000 | 0.01 | |
UC | 33.32 ± 31.15 | 39.88 ± 35.63 | 28.31 ± 34.23 | |||||||
Appetite loss | RT-HIIT | 19.77 ± 29.00 | 13.73 ± 24.59 | 5.29 ± 13.66 | RT-HIIT vs UC | − 4.01 | − 11.46 | 3.42 | 0.579 | − 0.37 |
AT-HIIT | 24.50 ± 26.70 | 20.00 ± 26.89 | 3.33 ± 11.81 | AT-HIIT vs UC | − 8.38 | − 15.94 | − 0.82 |
0.024
| − 0.66 | |
UC | 13.64 ± 22.17 | 19.05 ± 27.60 | 8.81 ± 22.79 | |||||||
Constipation | RT-HIIT | 21.63 ± 27.96 | 10.78 ± 22.63 | 10.05 ± 19.52 | RT-HIIT vs UC | 0.40 | − 6.95 | 7.75 | 1.000 | − 0.08 |
AT-HIIT | 21.45 ± 27.09 | 12.22 ± 21.23 | 2.22 ± 8.38 | AT-HIIT vs UC | − 8.42 | − 15.81 | − 1.03 |
0.019
| − 0.37 | |
UC | 18.70 ± 26.87 | 14.88 ± 24.55 | 9.43 ± 18.92 | |||||||
Diarrhea | RT-HIIT | 14.52 ± 22.58 | 8.82 ± 19.63 | 6.88 ± 14.86 | RT-HIIT vs UC | 2.65 | − 4.55 | 9.84 | 1.000 | 0.13 |
AT-HIIT | 13.15 ± 22.87 | 18.89 ± 28.37 | 7.77 ± 18.78 | AT-HIIT vs UC | 2.77 | − 4.48 | 10.02 | 1.000 | 0.23 | |
UC | 15.78 ± 24.05 | 8.33 ± 17.12 | 5.03 ± 13.71 | |||||||
Financial difficulties | RT-HIIT | 21.73 ± 31.75 | 25.00 ± 35.21 | 17.46 ± 29.85 | RT-HIIT vs UC | 0.23 | − 9.73 | 10.20 | 1.000 | 0.04 |
AT-HIIT | 16.54 ± 26.85 | 22.78 ± 34.98 | 12.23 ± 26.03 | AT-HIIT vs UC | − 3.17 | − 13.23 | 6.88 | 1.000 | − 0.04 | |
UC | 20.11 ± 31.95 | 19.05 ± 33.55 | 16.98 ± 32.44 |
Adjusted group differences in mean change from baseline to 12 months | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
Baseline | 16 weeks | 12 months | Mean change | Lower bound 95% CI | Upper bound 95% CI | p value | ES | |||
MSAS questionnaire | Mean ± SD | Mean ± SD | Mean ± SD | |||||||
Symptom burden | RT-HIIT | 0.91 ± 0.72 | 0.77 ± 0.62 | 0.67 ± 0.63 | RT-HIIT vs UC | − 0.14 | − 0.35 | 0.08 | 0.394 | − 0.41 |
AT-HIIT | 0.75 ± 0.58 | 0.66 ± 0.59 | 0.50 ± 0.47 | AT-HIIT vs UC | − 0.27 | − 0.49 | − 0.06 |
0.008
| − 0.46 | |
UC | 0.70 ± 0.73 | 0.89 ± 0.67 | 0.72 ± 0.69 | |||||||
Physical symptoms | RT-HIIT | 0.74 ± 0.60 | 0.68 ± 0.57 | 0.36 ± 0.35 | RT-HIIT vs UC | − 0.17 | − 0.33 | 0.00 |
0.049
| − 0.65 |
AT-HIIT | 0.67 ± 0.49 | 0.75 ± 0.59 | 0.34 ± 0.31 | AT-HIIT vs UC | − 0.21 | − 0.38 | − 0.04 |
0.008
| − 0.61 | |
UC | 0.51 ± 0.56 | 0.77 ± 0.62 | 0.48 ± 0.52 | |||||||
Psychological symptoms | RT-HIIT | 0.97 ± 0.76 | 1.02 ± 0.77 | 0.87 ± 0.77 | RT-HIIT vs UC | − 0.09 | − 0.35 | 0.18 | 1.000 | − 0.30 |
AT-HIIT | 0.81 ± 0.64 | 0.88 ± 0.73 | 0.69 ± 0.56 | AT-HIIT vs UC | − 0.24 | − 0.50 | 0.03 | 0.091 | − 0.38 | |
UC | 0.78 ± 0.77 | 1.11 ± 0.83 | 0.88 ± 0.80 | |||||||
Total symptoms | RT-HIIT | 0.74 ± 0.53 | 0.74 ± 0.50 | 0.52 ± 0.43 | RT-HIIT vs UC | − 0.14 | − 0.29 | 0.00 |
0.044
| − 0.46 |
AT-HIIT | 0.65 ± 0.41 | 0.76 ± 0.51 | 0.44 ± 0.33 | AT-HIIT vs UC | − 0.19 | − 0.33 | − 0.05 |
0.003
| − 0.46 | |
UC | 0.58 ± 0.50 | 0.85 ± 0.60 | 0.58 ± 0.50 |
Adjusted group differences in mean change from baseline to 12 months | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
Baseline | 16 weeks | 12 months | Mean change | Lower bound 95% CI | Upper bound 95% CI | p value | ES | |||
Mean ± SD | Mean ± SD | Mean ± SD | ||||||||
Body mass (kg) | RT-HIIT | 68.65 ± 11.34 | 69.47 ± 10.56 | 68.10 ± 9.64 | RT-HIIT vs UC | − 1.55 | − 3.56 | 0.47 | 0.195 | − 0.22 |
AT-HIIT | 67.66 ± 13.00 | 67.34 ± 14.45 | 66.59 ± 10.89 | AT-HIIT vs UC | − 2.28 | − 4.29 | − 0.26 |
0.021
| − 0.24 | |
UC | 69.07 ± 10.97 | 71.01 ± 11.66 | 70.93 ± 11.77 | |||||||
Body mass index (kg/m2) | RT-HIIT | 25.07 ± 4.28 | 25.38 ± 3.92 | 24.55 ± 3.19 | RT-HIIT vs UC | − 0.56 | − 1.06 | − 0.06 |
0.021
| − 0.38 |
AT-HIIT | 24.76 ± 4.41 | 24.64 ± 4.79 | 24.17 ± 3.59 | AT-HIIT vs UC | − 0.91 | − 1.41 | − 0.42 |
< 0.001
| − 0.39 | |
UC | 24.96 ± 4.23 | 25.75 ± 4.52 | 26.05 ± 4.61 | |||||||
Estimated VO2 peak (L/min) | RT-HIIT | 2.25 ± 0.50 | 2.18 ± 0.57 | 2.51 ± 0.67 | RT-HIIT vs UC | 0.15 | − 0.08 | 0.37 | 0.370 | 0.19 |
AT-HIIT | 2.10 ± 0.47 | 2.08 ± 0.49 | 2.33 ± 0.60 | AT-HIIT vs UC | 0.06 | − 0.17 | 0.28 | 1.000 | 0.14 | |
UC | 2.19 ± 0.53 | 1.93 ± 0.53 | 2.35 ± 0.65 | |||||||
Estimated VO2 peak (mL/kg/min) | RT-HIIT | 33.45 ± 7.91 | 31.70 ± 8.26 | 36.27 ± 9.11 | RT-HIIT vs UC | 3.20 | − 0.17 | 6.57 | 0.068 | 0.40 |
AT-HIIT | 31.30 ± 6.65 | 31.36 ± 6.27 | 35.04 ± 9.90 | AT-HIIT vs UC | 3.08 | − 0.26 | 6.43 | 0.081 | 0.56 | |
UC | 32.40 ± 7.79 | 27.55 ± 6.64 | 32.09 ± 8.33 | |||||||
Isometric mid-thigh pull (kg) | RT-HIIT | 87.23 ± 29.55 | 100.24 ± 34.31 | 100.22 ± 29.29 | RT-HIIT vs UC | 15.90 | 6.11 | 25.70 |
< 0.001
| 0.73 |
AT-HIIT | 78.35 ± 25.11 | 88.26 ± 23.02 | 97.10 ± 30.26 | AT-HIIT vs UC | 17.66 | 7.64 | 27.67 |
< 0.001
| 1.03 | |
UC | 89.32 ± 25.27 | 85.81 ± 25.96 | 82.05 ± 31.23 | |||||||
Handgrip surgery side (kg) | RT-HIIT | 28.40 ± 5.04 | 29.44 ± 5.27 | 29.86 ± 6.25 | RT-HIIT vs UC | 3.23 | 1.45 | 5.01 |
< 0.001
| 0.70 |
AT-HIIT | 28.44 ± 4.96 | 28.08 ± 5.29 | 29.93 ± 5.87 | AT-HIIT vs UC | 3.13 | 1.39 | 4.88 |
< 0.001
| 0.71 | |
UC | 28.99 ± 6.16 | 27.72 ± 5.78 | 26.51 ± 7.32 | |||||||
Handgrip non-surgery side (kg) | RT-HIIT | 27.71 ± 4.93 | 28.39 ± 5.54 | 29.12 ± 6.70 | RT-HIIT vs UC | 2.87 | 0.85 | 4.89 |
0.002
| 0.57 |
AT-HIIT | 27.87 ± 5.44 | 27.41 ± 5.48 | 29.55 ± 6.47 | AT-HIIT vs UC | 2.71 | 0.73 | 4.69 |
0.003
| 0.59 | |
UC | 28.47 ± 6.50 | 27.18 ± 6.33 | 26.62 ± 6.89 |