Breast Neoplasm Clinical Trial
Official title:
Effects of Combined Training on Quality of Life, Neuromuscular and Cardiorespiratory Parameters in Patients Who Have Completed the Primary Treatment for Breast Cancer: a Randomized Clinical Trial
The aim of the present study is analyze the effects of combined training program (resistance and aerobics) in comparison with a non-training group on quality of life, as well as on neuromuscular and cardiorespiratory parameters in breast cancer patients in stages one to three who have finished their treatment, such as surgery, chemotherapy and radiotherapy. Therefore, 42 women will be randomly divided into two groups: combined training group and control group. The subjects of the combined training group will undergo the intervention three times a week for eight weeks. The combined group will carry out both resistance and aerobic exercises in the same session. The resistance training will be comprised by ten exercises which will alternate body segments with maximum repetitions in the first set and the lower limit of the repetitions interval in the next sets. Along the training, the number of series will be increased whereas the number of repetitions will be decreased. The intensity of the aerobic exercises will be based on the percentage of the heart rate of the anaerobic threshold on the first weeks and on the speed of the anaerobic and aerobic threshold on the last weeks. Before and after the intervention, there will be evaluation of maximal dynamic strength of knee extensors and elbow flexors, maximum voluntary isometric contraction of knee extensors, maximum muscular activity of vastus lateralis and rectus femoris, muscle thickness of knee extensors, peak oxygen uptake and ventilatory threshold, quality of life and cancer-related fatigue. Data will be analyzed by Generalized Estimating Equations (GEE) and Bonferroni's post-hoc (α=0,05), including both protocol and intention to treat.
According to the World Health Organization, breast cancer is the most common one among women,
both in developed and developing countries. It accounts for 23% of all breast cancer cases
worldwide whereas, in Brazil, it represents 25% of new cases per year. However, its mortality
rate has increasingly decreased due to advances in screening protocols, diagnoses and
treatment in the last decades. Even so, breast cancer and its treatment might cause
psychological and physiological side effects that can affect patients' quality of life.
There is evidence that increase in physical activity generates important physical and
psychological benefits to patients with cancer. Studies with breast cancer survivors have
shown that the fact that the patients become physically active after the diagnosis leads to a
24-67% decrease in total death risk and 50-53% decrease in death related to breast cancer, by
comparison with sedentary patients.
Reviews, systematic reviews and metaanalysis of studies that investigated the effects of
interventions with physical exercise programs on health outcomes in breast cancer survivors
showed the benefits brought to these patients by exercise. However, these reviews have also
called the attention of the scientific community regarding the need to standardize measures
of outcomes and intervention methods of evaluation since variations found in the studies make
it difficult to reach definite conclusions. Furthermore, type, frequency, intensity and
duration of exercise sessions to reach beneficial effects on important health parameters for
breast cancer have not been well established yet. Therefore, this study aims at analyzing the
effects of combined training program (resistance and aerobics), in comparison with a
non-training group, on quality of life, as well as on neuromuscular and cardiorespiratory
parameters in breast cancer patients in stages one to three who have finished their
treatment, such as surgery, chemotherapy and radiotherapy.
Methodology: This trail will be carried out with women with histological confirmed breast
cancer who have already completed the primary treatment for breast cancer (including surgery,
radiation therapy and chemotherapy) from 6 months to 5 years but keep on hormone therapy.
After baseline assessments, the eligible participants will be randomized to the combined
exercise group or control non-exercising group. The combined exercise group will follow an
eight week exercising program, which consists of three weekly exercise sessions. Each session
will last around 60 minutes and will include strength training (with machines and elastic
bands) and aerobic exercises on treadmills. Workouts will be guided and supervised by
previously trained physical education professionals and physiotherapists. The strength
training will comprise nine exercises, which will alternate body segments with maximum
repetitions in the first set and the inferior limit of repetitions in the second set. Along
the training, the number of series will increase whereas the number of repetitions will
decrease. The intensity of the aerobic exercises will be based on the percentage of cardiac
frequency of anaerobic threshold. All exercise sessions will take place at the Physical
Education School at the Pelotas Federal University, located in Pelotas, Rio Grande do Sul,
Brazil.
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