Training in breast cancer patients: a longitudinal study

INTRODUCTION Human movement can be altered by the ineffective functioning of the nervous system, both central and peripheral, and not least by the muscle-joint system (Seymour 2008 Hinman 2004). Breast cancer can induce hypokinesia, leading to cachexia in the most severe cases (Muscaritoli et al. 2006). Adapted physical exercise becomes a useful tool which combines drug therapy and physiotherapy in order to maintain remaining motor abilities. These, if not solicited adequately and constantly, undergo a progressive deterioration which compounds biological ageing . AIM The aim of this research was to evaluate variations in shoulder joint mobility, maximum aerobic power (VO2 Max) and fat free mass in relation to different training protocols implemented in the post acute phase in patients having undergone an operation for breast cancer. METHODS The study focused on 100 patients having undergone an operation for breast cancer around 3 months previously. They were divided into 4 groups: 3 experimental and one control. Each experimental group completed 4 months of training three times a week (about 45 minutes). The 3 experimental groups performed the following training protocols: One group (age 56±5 years old, height 164±5 cm, weight 69±17 kg, BMI 25±6 kg/h2) performed muscle training with micro-loads (GML). GH, the second group (age 53±5 years, height 164±5 cm, weight 68±13 kg , BMI 25±5 kg / h2), performed a micro-gravity exercise (aqua gym). The third group, GA (age 54±6 years, height 163±5 cm, weight 67±16 kg, BMI 25±5 kg/h2) performed steady state training (65-75% HR max). The GC control group (age 55±6 years, height 165±9 cm, weight 69±14 kg BMI 25±4 kg/h2) did not perform any structured physical activity. The following functional assessments were performed before (T0) and after (T1) the training period: 1) Intra (SOI) and extra (SOE) rotation of the arm abducted to 90° for the analysis of the gleno-humeral joint. 2) The Oja and Laukkanen Test: for indirect assessment of VO2 Max. 3) The impedance meter: for fat free mass assessment RESULTS The data analysis (Wilcoxon test) showed statistical significance as follows: VO2Max: GP, ns; GH, ns; GAP <0.001, + 3%; GC, P <0.001, -1%. CSI: GP, P <0.001, + 7%; GH, P <0.01, + 7%; GA, P <0.01, + 3%; GC, ns .. CSE: GP, P <0.001, + 14%; GH, P <0.05, + 6%; GA, P <0.05, + 4%; GC, ns. FFM, GP: P <0.01, + 2%; GH, ns; GA ns; GC, ns. Fat free mass: GP, 0.01, +2%; GH, 0.06, +1%; GA, 0.05, +1% GC, 0.005, -1%. DISCUSSION/CONCLUSION Aerobic training improves maximal aerobic power even in patients with post-operative breast cancer. Both aqua-fitness and treadmill exercises increase glenohumeral joint mobility. TRAINING WITH micro-loads reduces the fat free mass. BIBLIOGRAPHY 1 Simon Seymour. The human body. 1st ed. New York : Smithsonian/Collins, c2008 2 Hinman MR, Comparison of thoracic kyphosis and postural stiffness in younger and older women, Spine J. (2004) Jul-Aug;4(4):413-7 3 Muscaritoli M, Bossola M, Aversa Z, et al.. Prevention and treatment of cancer cachexia: new insights into an old problem. Eur J Oncol, 2006; 42(1): 31-41 4 Burleson MA , O'Bryant HS, Stone MH, Collins MA, Triplett-McBride T., Effect of weight training exercise and treadmill exercise on post-exercise oxygen consumption Medicine & Science in Sports & Exercise. 30(4):518-522, April 1998.