Clinical and Translational Research
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
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
ARTICLE HIGHLIGHTS
Research background

Exercise is an efficacious strategy to improve aerobic capacity of breast cancer survivors (BCS) but has not been consistently evaluated with gold standard testing in community-based settings.

Research motivation

As a growing number of BCS are in need of community-based exercise access, providing effective interventions is paramount to their long term health and functionality.

Research objectives

The objective was to use gold standard testing to determine whether breast cancer survivors exhibit similar improvement in aerobic capacity (maximal oxygen consumption [VO2]) following community-based exercise compared to interventions in laboratory settings.

Research 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.

Research results

Both BCS (n = 31) and CTL (n = 15) groups significantly improved physical and functional capacity following training (VO2peak +1.2 mL/kg/min, P = 0.030; 6MWT +35 meters, P < 0.001; TUG -0.44 s; P < 0.01). Peak cycling power improved in both groups with BCS exhibiting 10 watts more improvement than CTL (P = 0.020). Average exercise ATT of 71%, 34/48 possible days) is in accordance with previous work, and the modest compliance (60% aerobic, < 40% resistance) emphasizes the challenges of exercise engagement in clinical populations.

Research conclusions

A community-based exercise program can effectively improve aerobic capacity and physical function for early stage breast cancer survivors 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.

Research perspectives

Providing BCS with accessible and effective exercise interventions is a critical component in survivorship and should be continually evaluated with gold standard outcomes, especially because it is not yet a standard intervention of oncology practice.