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Physical Rehabilitation in Breast Cancer Patients Which Tests to Adapt Training Program?
Annals of Oncology 25 (Supplement 4): iv85–iv109, 2014 doi:10.1093/annonc/mdu327.70
breast cancer, early stage PHYSICAL REHABILITATION IN BREAST CANCER PATIENTS WHICH TESTS TO ADAPT TRAINING PROGRAM?
Aim: Numerous studies report that adapted exercise training is a recommended component of rehabilitation in patients receiving adjuvant treatment for breast cancer. Peak oxygen consumption (VO2peak) obtained from cardiopulmonary exercise testing (CPET) are used for determine the intensity of exercise training program. However, CPET is relatively expensive and time consuming and distance walked during a six-minute walk test (6-MWT) is commonly employed in clinical practice for determine cardiorespiratory fitness (CRF). However, the relationship between VO2peak and 6 MWD has not been clearly defined in cancer rehabilitation program. Methods: 79 subjects (median age 50 years (35-70); stage I to III breast cancer) were evaluated before adjuvant chemotherapy and radiotherapy. They were included in an adapted physical activity program based on cardiopulmonary tests. They performed, under the supervision of an exercise physiologist, a 6MWT and a incremental physician-supervised CPET performed on an electronically-braked cycle ergometer. Age- and sex- predicted 6MWT was calculated from the equation of Enright, maximal oxygen uptake was the highest oxygen uptake during exercise and ventilatory threshold (VT) was determined by a systematic increase in the pulmonary ventilation during exercise. Results: Patients covered a distance of 526 ± 54 m during 6MWT at an average of 129 ± 16 beats per minute (bpm) of peak heart rate (PHR) and achieved a VO2peak of 22.6 ± 4.5 ml · kg − 1 · min− 1 at an average of 130 ± 14 bpm of PHR at VT. The distance walked was significantly correlated ( p < 0.001) but weakly with VO2peak (r = 0.38). Therefore, PHR during 6MWT and PHR (corresponding to the first VT) during VO2peak are significantly and strongly correlated ( p < 0.0001and r = 1). Conclusions: CPET with VO2peak may be the ideal method of measuring aerobic physical condition in cancer patients; however, this method of measurement of VO2max with CPET is not used easily in clinical oncology. PHR collected during the 6MWT seem to be a simple alternative parameter to guide exercise prescription in this cancer population. The implementation of these tests on training programs will describe. Disclosure: All authors have declared no conflicts of interest.
© European Society for Medical Oncology 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: [email protected].
Downloaded from https://academic.oup.com/annonc/article-abstract/25/suppl_4/iv107/2241072 by guest on 25 October 2019
C. Laval1, F. Vincent1, M. Antonini1, S. Leobon2, L. Venat-Bouvet2, N. Tubiana-Mathieu2 1 Physiology, University Hospital, Limoges, FRANCE 2 Medical Oncology, University Hospital, Limoges, FRANCE
abstracts
325P
breast cancer, early stage PHYSICAL REHABILITATION IN BREAST CANCER PATIENTS WHICH TESTS TO ADAPT TRAINING PROGRAM?
Aim: Numerous studies report that adapted exercise training is a recommended component of rehabilitation in patients receiving adjuvant treatment for breast cancer. Peak oxygen consumption (VO2peak) obtained from cardiopulmonary exercise testing (CPET) are used for determine the intensity of exercise training program. However, CPET is relatively expensive and time consuming and distance walked during a six-minute walk test (6-MWT) is commonly employed in clinical practice for determine cardiorespiratory fitness (CRF). However, the relationship between VO2peak and 6 MWD has not been clearly defined in cancer rehabilitation program. Methods: 79 subjects (median age 50 years (35-70); stage I to III breast cancer) were evaluated before adjuvant chemotherapy and radiotherapy. They were included in an adapted physical activity program based on cardiopulmonary tests. They performed, under the supervision of an exercise physiologist, a 6MWT and a incremental physician-supervised CPET performed on an electronically-braked cycle ergometer. Age- and sex- predicted 6MWT was calculated from the equation of Enright, maximal oxygen uptake was the highest oxygen uptake during exercise and ventilatory threshold (VT) was determined by a systematic increase in the pulmonary ventilation during exercise. Results: Patients covered a distance of 526 ± 54 m during 6MWT at an average of 129 ± 16 beats per minute (bpm) of peak heart rate (PHR) and achieved a VO2peak of 22.6 ± 4.5 ml · kg − 1 · min− 1 at an average of 130 ± 14 bpm of PHR at VT. The distance walked was significantly correlated ( p < 0.001) but weakly with VO2peak (r = 0.38). Therefore, PHR during 6MWT and PHR (corresponding to the first VT) during VO2peak are significantly and strongly correlated ( p < 0.0001and r = 1). Conclusions: CPET with VO2peak may be the ideal method of measuring aerobic physical condition in cancer patients; however, this method of measurement of VO2max with CPET is not used easily in clinical oncology. PHR collected during the 6MWT seem to be a simple alternative parameter to guide exercise prescription in this cancer population. The implementation of these tests on training programs will describe. Disclosure: All authors have declared no conflicts of interest.
© European Society for Medical Oncology 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: [email protected].
Downloaded from https://academic.oup.com/annonc/article-abstract/25/suppl_4/iv107/2241072 by guest on 25 October 2019
C. Laval1, F. Vincent1, M. Antonini1, S. Leobon2, L. Venat-Bouvet2, N. Tubiana-Mathieu2 1 Physiology, University Hospital, Limoges, FRANCE 2 Medical Oncology, University Hospital, Limoges, FRANCE
abstracts
325P