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Simple Summary Physical activity has proven to be effective in breast cancer patients. Appropriate exercise intensity for each patient is necessary to maintain this practice in patients with possible comorbidities and potential adverse events of specific treatments. These programs should be proposed to many patients so to prescribe the adapted program; this will necessitate easy and cost-effective tests. It is useful to use an adapted target heart rate (HR) to prescribe exercise intensity. In this work, we assessed the potential equivalence of the ventilatory threshold HR obtained during a cardiopulmonary exercise test and the HR measured over the last 3 min of the six-minute walk test (6MWT-HR). At baseline, the 6MWT-HR was in good agreement and showed moderate but statistical correlation with the VT-HR in breast cancer patients. The best correlation between these two tests was obtained after the APA program and chemotherapy. These results were independent of body mass index. The 6MWT is useful to prescribe APA programs before and also after chemotherapy concomitant with physical activity. Abstract Background: Adapted physical activity (APA) aids breast cancer patients. It is necessary to use an adapted target heart rate (HR) when prescribing exercise intensity. Methods: In total, 138 patients previously included in two published randomized clinical trials underwent the CPET and 6MWT before and after adjuvant therapy. Of these patients, 85 had performed APA, and 53 had received only the usual therapy. HRs were recorded during the two tests. Results: Before starting chemotherapy, good agreement (intraclass correlation (ICC) 0.69; confidence interval at 95% IC0.95 (0.591–0.769); p < 0.001) and a moderate correlation were evident between the 6MWT-HR and ventilatory threshold HR of the CPET (r = 0.70; p < 0.001). Good agreement and a high positive correlation were noted only in the group who engaged in APA (ICC 0.77; IC0.95 (0.659–0.848); p < 0.001; r = 0.8; p < 0.01); moderate agreement and a moderate positive correlation were apparent in the control group (ICC 0.57; IC0.95 (0.329–0.74); p < 0.001; r = 0.6; p < 0.01). The correlations were independent of age and body mass index. Conclusions: The 6MWT-HR can be used to prescribe exercise intensity for breast cancer patients both before and after specific treatment with concomitant APA.

Background. Past twenty years, clinical research focuses on the fatigue and the place of physical activity during the treatment of women with breast cancer. Use of cardiopulmonary exercise test (CPET) for determination of peak oxygen consumption (VO2peak) provides the gold standard assessment of aerobic capacity. Our first pilot study was designed to evaluate the effects of a training program during chemotherapy in women with breast cancer showed a significant improvement of VO2peak after treatment (1). So, we performed a phase III study, to assess the effects of a home-based adapted physical activity (APA) program in women treated by adjuvant or neoadjuvant chemotherapy and radiotherapy for breast cancer versus control group (without APA). The main criterion was cardiopulmonary function, measured by VO2peak, at 27 weeks after radio-chemotherapy (RT-CT) between the 2 groups. Methods. Participants were randomized into 2 groups: Arm A (aerobic and strength training) during the 27 weeks of treatment (RT-CT); Arm B (control group). This study included 3 assessments phases (T0: before RT-CT; T1: week 27; and T2: final evaluation at the 54th week). These assessments included: cardiopulmonary exercise test (CPET) with maximal oxygen uptake test (VO2peak), 6 Minutes Walking Test (6MWT) and health-related quality of life. The APA program consisted in 2 sessions of endurance (walking and/or cycling) and 1 session of resistance (elastic band) per week. Training endurance intensity was based on the first ventilator threshold and coached by a specialist. Results. Forty-four subjects were included from June 2012 to June 2013. At baseline (T0), the average age was 52,3 ± 11,7 years for Arm A versus 48,8 ± 8 years for Arm B. Before treatment VO2peak was 23,2 ± 4,9 ml.kg-1.min-1 for Arm A and 22,9 ± 5,4 ml.kg-1.min-1 for Arm B. After treatment (T1), VO2peak was significantly different between the two groups (3.5 ml.kg-1.min) with 24.6 ± 5 ml.kg-1.min-1 vs 20.97 ± 4.8 ml.kg-1.min-1 for Arm A and Arm B respectively (P = . 048). Walking distance on 6MWT improved by 19,7m (P = .016) for training group and decreased by 20,7m (P = .043) for control group. At 6 months (T2), VO2peak was not different between the two groups (P = .069). Arm A continued to increase (26,2 ± 5,6 ml.kg-1.min-1) while Arm B recovered his baseline value (22,3 ± 5,6 ml.kg-1.min-1). Similar results was showed in 6MWT, compared with T1, the two Arms A and B increased by 12,9m (P = .063) and 17,6m (P = .27) respectively. Conclusion. Home-based APA program improved aerobic function and exercise capacity during RT-CT. The exercise during treatment is feasible, safe, and provides a real benefit of physical fitness. In addition, this activity has been performed at home. Keywords. Cardiorespiratory Fitness, VO2peak, Breast Cancer, Adjuvant or Neoadjuvant Chemotherapy, Physical Function, Adapted Physical Activity. Reference. 1. F.Vincent JL.Labourey, S.Leobon, MT.Antonini, S. Lavau-Denes, N. Tubiana-Mathieu. Effects of a home-based walking training program on cardiorespiratory fitness in breast cancer patients receiving adjuvant chemotherapy a pilot study. Eur J Phys Rehabil Med. 2013 Jun;49(3):319-29. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-09-10.

Resume Introduction L’objectif de notre travail est d’evaluer les benefices d’un programme d’entrainement mixte sur la variabilite de la frequence cardiaque, la composition corporelle et sur la vitalite de la femme âgee de plus de 60 ans. Methodologie La population d’etude est composee d’un groupe experimental (n = 11) ayant suivi un programme d’entrainement de quatre mois et d’un groupe temoin (n = 14). Chaque sujet a beneficie d’une evaluation anthropometrique, cardiovasculaire (analyse de la variabilite de la frequence cardiaque) et psychologique. Conclusion Cette etude nous permet d’affirmer qu’un programme d’activite physique d’intensite moderee peut induire des benefices sur le plan physique, anthropometrique et diminuer le risque de maladies cardiovasculaires.

Breast cancer chemotherapy is associated with a decline in measured cardiorespiratory fitness and increased fatigue. Physical activity has emerged as a feasible intervention to limit these side effects. Quantitative evaluation is necessary to propose a better-adapted physical activity and to evaluate efficacy.We undertook a prospective study to assess the effects of a home-based adapted physical activity (APA) program on aerobic capacity, strength, and fatigue in women treated with adjuvant or neoadjuvant chemotherapy for breast cancer versus usual care.This was an open two-arm, randomized controlled trial.Study included outpatient groups in the Department of Physiology and Medical Oncology of a hospital in France.Forty-four patients treated with adjuvant or neoadjuvant chemotherapy for breast cancer.Patients were randomly assigned to a control group or an APA group. Intervention consisted of a 3-week, home-based, supervised, combined APA program (endurance and resistance training) during 27 weeks. The primary endpoint was cardiopulmonary function assessed by maximal peak oxygen consumption (VO2peak). Secondary endpoints included a 6-minute Walking Test (6MWT), and assessment of muscular strength, fatigue, quality of life, physical activity level, and anxiety/depression.At 27 weeks, VO2peak increased by 1.83±0.68 ml.min-1.kg-1 in the APA group (P=0.009) and decreased by 1.31±0.65 mL.min-1.kg-1 in the control group (P=0.046). The difference between the two groups was not significant (2.26±1.53 mL.min-1.kg-1, P=0.140) in intention-to-treat analysis, but it was significant in per protocol analysis (3.49±1.64 mL.min-1.kg-1, P=0.049). At 27 and 54 weeks, no significant differences were observed between the two groups for the cardiopulmonary exercise test, 6MWT, quadriceps strength, or quality of life.In breast cancer patients, a home-based supervised program during chemotherapy and radiotherapy treatment may be safe, feasible and increase VO2peak. In this study, heavy evaluation tests explain patient's non-adherence and do not permit to obtain statistically significant results between APA and control groups.Aerobic home-based adapted physical activity is beneficial on aerobic capacity.