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Short-term pre-operative high-intensity interval training does not improve fitness of colorectal cancer patients.

ABSTRACT: BACKGROUND:Pre-operative cardiorespiratory fitness (CRF) in colorectal cancer (CRC) patients has been shown to affect post-operative outcomes. The aim of this study was to test the feasibility of high-intensity interval training (HIIT) for improving fitness in pre-operative CRC patients within the 31-day cancer waiting-time targets imposed in the UK. METHODS:Eighteen CRC patients (13 males, mean age: 67 years (range: 52-77 years) participated in supervised HIIT on cycle ergometers 3 or 4 times each week prior to surgery. Exercise intensity during 5 × 1-minute HIIT intervals (interspersed with 90-second recovery) was 100%-120% maximum wattage achieved at a baseline cardiopulmonary exercise test (CPET). CPET before and after HIIT was used to assess CRF. RESULTS:Patients completed a mean of eight HIIT sessions (range 6-14) over 19 days (SD 7). There was no significant increase in VO2 peak (23.9 ± 7.0 vs 24.2 ± 7.8 mL/kg/min (mean ± SD), P = 0.58) or anaerobic threshold (AT: 14.0 ± 3.4 vs 14.5 ± 4.5 mL/kg/min, P = 0.50) after HIIT. There was a significant reduction in resting systolic blood pressure (152 ± 19 vs 142 ± 19 mm Hg, P = 0.0005) and heart rate at submaximal exercise intensities after HIIT. CONCLUSIONS:Our pragmatic HIIT exercise protocol did not improve the pre-operative fitness of CRC patients within the 31-day window available in the UK to meet cancer surgical waiting-time targets.

SUBMITTER: Boereboom CL

PROVIDER: S-EPMC6771883 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Short-term pre-operative high-intensity interval training does not improve fitness of colorectal cancer patients.

Boereboom Catherine L CL Blackwell James E M JEM Williams John P JP Phillips Bethan E BE Lund Jonathan N JN

Scandinavian journal of medicine & science in sports 20190529 9

<h4>Background</h4>Pre-operative cardiorespiratory fitness (CRF) in colorectal cancer (CRC) patients has been shown to affect post-operative outcomes. The aim of this study was to test the feasibility of high-intensity interval training (HIIT) for improving fitness in pre-operative CRC patients within the 31-day cancer waiting-time targets imposed in the UK.<h4>Methods</h4>Eighteen CRC patients (13 males, mean age: 67 years (range: 52-77 years) participated in supervised HIIT on cycle ergometers ...[more]

PMID: 31116453

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Project description:PurposeImproving cardiopulmonary reserve, or peak oxygen consumption( V˙ O2peak ), may reduce postoperative complications; however, this may be difficult to achieve between diagnosis and surgery. Our primary aim was to assess the efficacy of an approximate 14-session, preoperative high-intensity interval training(HIIT) program to increase V˙ O2peak by a clinically relevant 2 ml·kg-1 ·min-1 . Our secondary aim was to document clinical outcomes.MethodologyIn this prospective study, participants aged 45-85 undergoing major abdominal surgery were randomized to standard care or 14 sessions of HIIT over 4 weeks. HIIT sessions involved approximately 30 min of stationary cycling. Interval training alternated 1 min of high (with the goal of reaching 90% max heart rate at least once during the session) and low/moderate-intensity cycling. Cardiopulmonary exercise testing(CPET) measured the change in V˙ O2peak from baseline to surgery. Clinical outcomes included postoperative complications, length of stay(LOS), and Short Form 36 quality of life questionnaire(SF-36).ResultsOf 63 participants, 46 completed both CPETs and 50 completed clinical follow-up. There was a significant improvement in the HIIT group's mean ± SD V˙ O2peak (HIIT 2.87 ± 1.94 ml·kg1 ·min-1 vs standard care 0.15 ± 1.93, with an overall difference of 2.73 ml·kg1 ·min-1 95%CI [1.53, 3.93] p < 0.001). There were no statistically significant differences between groups for clinical outcomes, although the observed differences consistently favored the exercise group. This was most notable for total number of complications (0.64 v 1.16 per patient, p = 0.07), SF-36 physical component score (p = 0.06), and LOS (mean 5.5 v 7.4 days, p = 0.07).ConclusionsThere was a significant improvement in V˙ O2peak with a four-week preoperative HIIT program. Further appropriately powered work is required to explore the impact of preoperative HIIT on postoperative clinical outcomes.

Project description:Background and aimExercise training regimes can lead to improvements in measures of cardiorespiratory fitness (CRF), improved general health, and reduced morbidity and overall mortality risk. High-intensity interval training (HIIT) offers a time-efficient approach to improve CRF in healthy individuals, but the relative benefits of HIIT compared with traditional training methods are unknown in across different disease cohorts.MethodsThis systematic review and meta-analysis compares CRF gains in randomized controlled trials of short-term (<8 wk) HIIT versus either no exercise control (CON) or moderate continuous training (MCT) within diseased cohorts. Literature searches of the following databases were performed: MEDLINE, EMBASE, CINAHL, AMED, and PubMed (all from inception to December 1, 2017), with further searches of Clinicaltrials.gov and citations via Google Scholar. Primary outcomes were effect on CRF variables: V˙O2peak and anaerobic threshold.ResultsThirty-nine studies met the inclusion criteria. HIIT resulted in a clinically significant increase in V˙O2peak compared with CON (mean difference [MD] = 3.32 mL·kg·min, 95% confidence interval [CI] = 2.56-2.08). Overall HIIT provided added benefit to V˙O2peak over MCT (MD = 0.79 mL·kg·min, 95% CI = 0.20-1.39). The benefit of HIIT was most marked in patients with cardiovascular disease when compared with MCT (V˙O2peak: MD = 1.66 mL·kg·min, 95% CI = 0.60-2.73; anaerobic threshold: MD = 1.61 mL·kg·min, 95% CI = 0.33-2.90).ConclusionsHIIT elicits improvements in objective measures of CRF within 8 wk in diseased cohorts compared with no intervention. When compared with MCT, HIIT imparts statistically significant additional improvements in measures of CRF, with clinically important additional improvements in V˙O2peak in cardiovascular patients. Comparative efficacy of HIIT versus MCT combined with an often reduced time commitment may warrant HIIT's promotion as a viable clinical exercise intervention.

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Short-term pre-operative high-intensity interval training does not improve fitness of colorectal cancer patients.

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Short-term pre-operative high-intensity interval training does not improve fitness of colorectal cancer patients.

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