An online home-based exercise program improves autonomic dysfunction in breast cancer survivors

Ana Myriam Lavín-Pérez; Daniel Collado-Mateo; Carmen Hinojo González; Marco Batista; Xián Mayo; Cristina Ruisánchez Villar; Alfonso Jiménez

doi:10.3389/fphys.2023.1256644

An online home-based exercise program improves autonomic dysfunction in breast cancer survivors

Front Physiol. 2023 Sep 29:14:1256644. doi: 10.3389/fphys.2023.1256644. eCollection 2023.

Authors

Ana Myriam Lavín-Pérez^{1

2

3}, Daniel Collado-Mateo¹, Carmen Hinojo González⁴, Marco Batista⁵, Xián Mayo¹, Cristina Ruisánchez Villar⁶, Alfonso Jiménez^{1

2

7}

Affiliations

¹ Sport Sciences Research Centre, Rey Juan Carlos University, Madrid, Spain.
² GO Fit LAB, GO Fit Life, Science and Technology, S.A., Madrid, Spain.
³ Program of Epidemiology and Public Health (Interuniversity), Ph.D. International School of Rey Juan Carlos University, Madrid, Spain.
⁴ Oncology Department, Hospital Universitario Marques de Valdecilla, Santander, Spain.
⁵ Sport, Health, and Exercise Research Unit (SHERU), Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal.
⁶ Cardiology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
⁷ Advanced Wellbeing Research Centre, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, United Kingdom.

Abstract

Introduction: Exercise interventions for breast cancer survivors have proved their potential to improve clinical, physical, and psychosocial outcomes. However, limited studies have explored exercise effects on autonomic dysfunction and the measurement of exercise tolerance and progression through daily heart rate variability (HRV). Purpose: To analyze the effects of a 16-wk exercise intervention on the autonomic modulation of breast cancer survivors, as well as to examine the evolution of daily measured HRV and its interaction with exercise sessions in this population. Methods: A total of 29 patients who had undergone chemotherapy and radiotherapy were randomly assigned to the exercise group or to the control group. The exercise intervention was delivered remotely through online meetings and consisted of supervised training resistance and cardiovascular exercise 3 times per week. During the intervention all patients measured their HRV daily obtaining the napierian logarithm of the root mean square of successive differences between normal heartbeats (lnrMSSD) and the napierian logarithm of the standard deviation of the interbeat interval of normal sinus beats (lnSDNN) values at four moments: day 0 (the morning of the training sessions), 24, 48, and 72 h after exercise. Results: The results revealed a significant interaction between group and months during the intervention period for lnrMSSD and lnSDNN (p < 0.001). Additionally, there were significant differences in lnSDNN recovery time between months (p < 0.05), while differences in lnrMSSD become apparent only 24 h after exercise (p = 0.019). The control group experienced a significant decrease in both variables monthly (p < 0.05) while exercise group experienced a significant increment (p < 0.05). Conclusion: HRV is daily affected by exercise training sessions in cancer patients. Although results strongly support the role of exercise as a post-chemotherapy and radiotherapy rehabilitation strategy for breast cancer survivors to improve autonomic imbalance, further research is necessary to validate these initial findings.

Keywords: autonomic dysfunction; breast cancer; heart rate variability; training program; treatments cardiotoxicity.

Grants and funding

The authors declare financial support was received for the research, authorship, and/or publication of this article. The author AL-P is supported by the Industrial Doctorate Spanish National grant program, part of the Strategic Plan on Science and Innovation Support of the Spanish Ministry of Science, Innovation and Universities. The predoctoral industry grant identification number is DIN 2018-010129.