Lee JT, Wagoner CW, Sullivan SA, Amatuli DJ, Nyrop KA, Hanson ED, Stoner L, Jensen BC, Muss HB, Battaglini CL. Impact of community-based exercise program participation on aerobic capacity in women with and without breast cancer. World J Clin Oncol 2021; 12(6): 468-481 [PMID: 34189070 DOI: 10.5306/wjco.v12.i6.468]
Corresponding Author of This Article
Claudio L Battaglini, PhD, Professor, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, 174 Country Club Road, Chapel Hill, NC 27599, United States. claudio@email.unc.edu
Research Domain of This Article
Oncology
Article-Type of This Article
Clinical and Translational Research
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Jun 24, 2021; 12(6): 468-481 Published online Jun 24, 2021. doi: 10.5306/wjco.v12.i6.468
Impact of community-based exercise program participation on aerobic capacity in women with and without breast cancer
Jordan T Lee, Chad W Wagoner, Stephanie A Sullivan, Dean J Amatuli, Kirsten A Nyrop, Erik D Hanson, Lee Stoner, Brian C Jensen, Hyman B Muss, Claudio L Battaglini
Jordan T Lee, Chad W Wagoner, Stephanie A Sullivan, Dean J Amatuli, Erik D Hanson, Lee Stoner, Claudio L Battaglini, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
Kirsten A Nyrop, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
Brian C Jensen, Department of Medicine, Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
Hyman B Muss, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27599, United States
Author contributions: Lee JT contributed to the conceptualization, project administration lead, and writing; Wagoner CW contributed to the project administration and editing; Sullivan SA contributed to the project administration; Amatuli DJ contributed to the project administration; Nyrop KA contributed to the conceptualization, critical appraisal of content, and editing; Hanson ED contributed to the conceptualization, project administration, and critical appraisal of content; Stoner L contributed to the conceptualization and editing; Jensen BC contributed to the project administration; Muss HB contributed to the conceptualization, critical appraisal of content, and editing; and Battaglini CL contributed to the conceptualization, methodology, editing, and critical appraisal of content.
Institutional review board statement: The study approved by the Protocol Review Committee of the UNC Lineberger Comprehensive Cancer Center and the UNC Institutional Review Board.
Clinical trial registration statement: This registration policy applies to registry trials. This study is registered at Get REAL and HEEL Research Program - Full Text View - ClinicalTrials.gov.
Informed consent statement: All participants provided written informed consent.
Conflict-of-interest statement: The authors do not have any conflict of interest disclaimers.
Data sharing statement: No data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Claudio L Battaglini, PhD, Professor, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, 174 Country Club Road, Chapel Hill, NC 27599, United States. claudio@email.unc.edu
Received: February 10, 2021 Peer-review started: February 10, 2021 First decision: March 17, 2021 Revised: March 27, 2021 Accepted: May 27, 2021 Article in press: May 27, 2021 Published online: June 24, 2021 Processing time: 130 Days and 6.8 Hours
Abstract
BACKGROUND
Evidence for exercise as an efficacious strategy to improve aerobic capacity of breast cancer survivors (BCS) has come largely from intervention studies conducted in laboratory settings. There is an increasing need to translate to community-type settings, but the efficacy of those interventions using gold standard evaluation is not well-established.
AIM
To investigate whether similar improvement in aerobic capacity (maximal oxygen consumption [VO2]) measured with gold standard testing can be achieved through a community-based setting in BCS.
METHODS
A peak cardiopulmonary exercise test (VO2peak), 6-min walk test (6MWT), and timed up and go test (TUG) were assessed pre- and post-16 wk of progressive intensity aerobic and strength training exercise at a community center.
RESULTS
The sample consisted of 31 early BCS (< 1 year since treatment completion) and 15 controls (CTLs). Both groups significantly improved VO2peak (+1.2 mL/kg/min; P = 0.030), 6MWT (+35 meters; P < 0.001), and TUG (-0.44 s; P < 0.01) following training. Both groups improved peak cycling power during the cardiopulmonary exercise test with BCS improving by +10 watts more than the CTLs (P = 0.020). Average exercise attendance was 71% (34 of 48 possible days), but compliant days averaged only 60% of total days for aerobic, and < 40% for strength in both groups.
CONCLUSION
Community-based exercise programs can be an effective strategy to improve aerobic capacity and physical function for early-stage BCS but potentially not to the same extent observed in laboratory-based randomized controlled trials. Further research is needed to explore barriers and facilitators of exercise engagement in community-based centers to maximize training benefits for adults with cancer.
Core Tip: Breast cancer survivors can improve aerobic capacity and physical function through participation in community-based exercise programs. However, these improvements may not be as substantial as those observed in laboratory-based randomized controlled trials. While community-based programs may provide cancer survivors better flexibility and access than laboratory settings, to maximize training benefits, continued work developing and testing exercise intervention prescriptions and associated outcomes is necessary in addition to exploring barriers and facilitators of exercise engagement for adults with cancer.
