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High-intensity interval training in the therapy and aftercare of cancer patients: a systematic review with meta-analysis

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Abstract

Purpose

This review and meta-analysis aimed to evaluate the effects of high-intensity interval training (HIIT) compared to usual care (UC) or moderate-intensity training (MIE) on physical fitness and health-related outcomes in cancer patients across all stages of therapy and aftercare.

Methods

Databases were systematically searched in accordance with the PRISMA guidelines until October 4th, 2018. Eligibility criteria included adult patients of various cancer types, performing HIIT vs. UC or MIE. Outcomes of interest included physical fitness (cardiorespiratory fitness [VO2peak] and functional capacity) and health-related outcomes (body composition, quality of life, cancer-related fatigue, and blood-borne biomarkers). Mean differences (MD) were calculated and pooled to generate effect sizes for VO2peak.

Results

The search identified 1453 studies, out of which 12 articles were included. The average duration of interventions was 6.7 ± 3.0 weeks, with 2.8 ± 0.5 sessions per week. The meta-analysis for VO2peak showed superiority of HIIT compared to UC (MD 3.73; 95% CI 2.07, 5.39; p < 0.001) but not MIE (MD 1.36; 95% CI − 1.62, 4.35; p = 0.370). Similarly, no superior effects of HIIT compared to MIE were found for quality of life or changes in lean mass, while evidence was provided for a larger reduction in fat mass.

Conclusion

This systematic review showed that short-term HIIT induces similar positive effects on physical fitness and health-related outcomes as MIE but seems to be superior compared to UC. Thus, HIIT might be a time-efficient intervention for cancer patients across all stages of therapy and aftercare.

Implications for Cancer Survivors

High-intensity interval training (HIIT) is superior compared to usucal care in improving physical fitness and health-related outcomes in cancer patients across all stages of therapy and aftercare. Currently, there is no evidence for the benefits of HIIT compared to aerobic training of moderate intensity (MIE) for changes in cardiorespiratory fitness, lean mass and patient-reported outcomes. Reductions in fat mass may be more pronounced in HIIT compared to MIE when training is performed in aftercare.

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The authors declare that this manuscript is not under consideration for publication elsewhere, that its publication is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out, and that, if accepted, it will not be published elsewhere in the same form, in English or in any other language, including electronically without the written consent of the copyright holder.

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Author notes

  1. Hendrik Mugele and Nils Freitag contributed equally to this work.

Authors and Affiliations

  1. Department of Sport Science, University of Innsbruck, Innsbruck, Austria

    Hendrik Mugele

  2. Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany

    Nils Freitag, Jannik Wilhelmi, Wilhelm Bloch & Moritz Schumann

  3. Department of Physical Education, Exercise, Health and Technology Centre, Shanghai Jiao Tong University, Shanghai, China

    Yanxiang Yang, Sulin Cheng & Moritz Schumann

  4. Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland

    Sulin Cheng

  5. The Exercise Translational Medicine Centre, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, 200240, China

    Sulin Cheng & Moritz Schumann

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  1. Hendrik Mugele
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Contributions

HM contributed to the design of the study, the literature search, data screening and extraction, statistical analyses, manuscript preparation and editing, and submission. NF contributed to the design of the study, the literature search, data screening and extraction, statistical analyses, manuscript preparation and editing, and submission. JW contributed to the design of the study as well as data screening and extraction. YY contributed to the data extraction, statistical analyses, and manuscript preparation. SC contributed to the data extraction and statistical analyses and contributed theoretical expertise and writing and editing of the manuscript. WB contributed to the data extraction and statistical analyses and contributed theoretical expertise and writing and editing of the manuscript. MS contributed to the design of the study, the literature search, data screening and extraction, and statistical analyses; provided methodological input and theoretical expertise; and contributed to writing and editing of the manuscript and submission.

Corresponding author

Correspondence to Moritz Schumann.

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Mugele, H., Freitag, N., Wilhelmi, J. et al. High-intensity interval training in the therapy and aftercare of cancer patients: a systematic review with meta-analysis. J Cancer Surviv 13, 205–223 (2019). https://doi.org/10.1007/s11764-019-00743-3

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