Energy System Assessment in Survivors of Breast Cancer

Phys Ther. 2020 Mar 10;100(3):438-446. doi: 10.1093/ptj/pzz177.

Abstract

Background: Survivors of breast cancer commonly report functional limitations, including cancer-related fatigue (CRF) and decreased aerobic capacity. One key gap is addressing the 3 energy systems (aerobic, anaerobic lactic, and alactic), requiring assessment to establish a baseline exercise intensity and duration.

Objective: This study examined the feasibility of energy system-based assessment, also providing descriptive values for assessment performance in this population.

Design: This was a cross-sectional study.

Methods: Seventy-two posttreatment survivors of breast cancer were recruited. Following a baseline musculoskeletal assessment, women attempted 3 energy system assessments: submaximal aerobic (multistage treadmill), anaerobic alactic (30-second sit-to-stand [30-STS]), and anaerobic lactic (adapted burpees). Heart rate (HR) and rating of perceived exertion (RPE) were recorded. Secondary outcomes included body composition, CRF, and upper- and lower-limb functionality.

Results: Seventy of 72 participants performed the 30-STS and 30 completed the adapted burpees task. HR and RPE specific to each task were correlated, reflecting increased intensity. Women reported low-moderate levels of CRF scores (3% [2.1]) and moderate-high functionality levels (upper-limb: 65.8% [23.3]; lower-limb: 63.7% [34.7]).

Limitations: All survivors of breast cancer had relatively low levels of CRF and moderate functioning. Additionally, on average, participants were classified as "overweight" based on BMI.

Conclusion: This study is the first to our knowledge to demonstrate feasibility of energy system assessment in survivors of breast cancer. Using a combination of HR and RPE, as well as baseline assessment of each energy system, clinicians may improve ability to prescribe personalized exercise and give patients greater ability to self-monitor intensity and progress.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anaerobic Threshold / physiology*
  • Body Composition
  • Breast Neoplasms / physiopathology*
  • Breast Neoplasms / therapy
  • Cancer Survivors*
  • Cross-Sectional Studies
  • Exercise / physiology*
  • Exercise Test / methods
  • Exercise Tolerance
  • Extremities / physiopathology
  • Feasibility Studies
  • Female
  • Heart Rate
  • Humans
  • Middle Aged
  • Muscle Fatigue / physiology
  • Physical Exertion
  • Physical Functional Performance*
  • Sitting Position
  • Standing Position