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Table 1 Summary of studies investigating the cardiovascular effects of exercise interventions during breast cancer treatment

From: Breast cancer treatment-associated cardiovascular toxicity and effects of exercise countermeasures

Author Patient population Exercise intervention Outcome
Courneya et al. 2007 [58] 242 women initiating adjuvant chemotherapy Supervised aerobic exercise, 15–45 min/d at 60 % - 80 % of VO2peak, 3 d/wk (n = 78); supervised resistance exercise, 2 sets of 9 exercises at 60 % - 70 % of 1-repetition maximum, 3 d/wk (n = 82); or usual care (n = 82). All interventions continued for the duration of chemotherapy (mean 17 wks). ↑ VO2peak and ↑ self-esteem with aerobic exercise compared to usual care; ↑ self–esteem, ↑ muscular strength, and ↑ lean body mass with resistance training compared to usual care.
Courneya et al. 2013 [59] 301 women initiating adjuvant chemotherapy Supervised aerobic exercise, 25–30 min/d at 55 % - 75 % of VO2peak, 3 d/wk (STD, n = 96); supervised aerobic exercise at 55 % - 75 % of VO2peak, 50–60 min/d, 3 d/wk (HIGH, n = 101); or combined supervised aerobic exercise (25–30 min/d) and resistance exercise (2 sets of 9 exercises at 60 % - 75 % of 1-repetition maximum), 50–60 min/d, 3 d/wk (COMB, n = 104). All interventions continued for the duration of chemotherapy (mean 16 weeks). Decline in VO2peak attenuated with HIGH compared to COMB. No significant difference between HIGH and STD on VO2peak.
Haykowsky et al. 2009 [60] 17 women receiving adjuvant trastuzumab Supervised aerobic exercise, 30–60 min/d at 60 % - 90 % of VO2peak, 3 d/wk × 4 mo. No change in VO2peak, SBP, or DBP; ↑ LVEDV, ↑LVESV, and ↓ LVEF with exercise.
Hornsby et al. 2014 [68] 20 women receiving neoadjuvant doxorubicin plus cyclophosphamide Supervised aerobic exercise, 15–45 min/d at 60 % - 70 % of VO2peak and planned interval sessions, 3 d/wk × 12 wks (n = 10); or usual care (n = 10) ↑ VO2peak with exercise
Kim et al. 2006 [69] 41 women undergoing adjuvant chemotherapy Supervised aerobic exercise, 30 min at 60 % - 70 % of VO2peak, 3 d/wk × 8 wks (n = 22); or control (n = 19) ↓ HR, ↓ SBP, ↑ VO2peak with aerobic exercise compared to control.
MacVicar et al. 1989 [70] 45 women receiving chemotherapy for stage II breast cancer Supervised aerobic exercise at 60 % - 85 % of maximum heart rate, 3 d/wk × 10 wks (n = 18); non-aerobic stretching and flexibility exercises (n = 11); or control (n = 16) ↑ VO2peak with aerobic exercise compared to non-aerobic stretching and control.
Segal et al. 2001 [71] 123 women with stage I/II breast cancer receiving adjuvant therapy (radiotherapy, hormonal therapy, or chemotherapy) Self-directed exercise at 50 % - 60 % of VO2peak, 5 d/wk × 26 wks (n = 40); supervised exercise at 50 % to 60 %% of VO2peak 3 d/wk and self-directed exercise at same level 2 d/wk × 26 wks (n = 42); or usual care (n = 41). ↑ VO2peak in supervised exercise group compared to control in patients not receiving chemotherapy; no difference between groups in VO2peak among patients receiving chemotherapy.
Vincent et al. 2013 [72] 42 women with stage I-III breast cancer beginning first line adjuvant chemotherapy Home-based walking program at 50 % - 60 % of maximum heart rate, 3 d/wk × 12 wks. ↑ VO2peak and ↑ 6MWT distance.