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Lower rate-pressure product during submaximal walking: a link to fatigue improvement following a physical activity intervention among breast cancer survivors

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Abstract

Purpose

Research showing a link between exercise-induced changes in aerobic fitness and reduced fatigue after a cancer diagnosis has been inconsistent. We evaluated associations of fatigue and rate-pressure product (RPP), a reliable index of myocardial oxygen demand, at rest and during submaximal walking following a physical activity intervention among post-primary treatment breast cancer survivors (BCS).

Methods

Secondary analyses of 152 BCS in a randomized controlled trial testing a physical activity intervention (INT) versus usual care (UC) were performed. The INT group completed counseling/group discussions along with supervised exercise sessions tapered to unsupervised exercise. Evaluations were made at baseline and immediately post-intervention (M3) on measures of physical activity (accelerometry), graded walk test, and average fatigue over the previous 7 days. RPP was calculated by dividing the product of heart rate and systolic blood pressure by 100.

Results

Resting and submaximal RPPs were significantly improved in both groups at M3; however, the magnitude of change (∆) was greater in the INT group from stage 1 (∆RPP1; INT −13 ± 17 vs. UC −7 ± 18; p = 0.03) through stage 4 (∆RPP4; INT −21 ± 26 vs. UC −9 ± 24; p < 0.01) of the walk test. The INT group reported significantly reduced fatigue (INT −0.7 ± 2.0 vs. UC +0.1 ± 2.0; p = 0.02) which was positively associated with ∆RPP during stages 2–4 of the walk test but not ∆aerobic fitness.

Conclusions

Lower RPP during submaximal walking was significantly associated with reduced fatigue in BCS.

Implications for Cancer Survivors

Exercise/physical activity training programs that lower the physiological strain during submaximal walking may produce the largest improvements in reported fatigue.

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Correspondence to Stephen J. Carter.

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Sources of funding

This project was supported by the National Institutes of Health Grants: R01CA136859 (L. Q. Rogers), R01DK049779 (G. R. Hunter), P30DK56336 (S. J. Carter), and R25CA47888 (S. J. Carter). Kerry S. Courneya is supported by the Canada Research Chairs Program.

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human rights

All procedures performed involving human participants were in accordance with the ethical standards of the University of Alabama at Birmingham and with the 1964 Helsinki declaration and its later amendments. Informed consent was obtained from all individual participants included in the present study.

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Carter, S.J., Hunter, G.R., McAuley, E. et al. Lower rate-pressure product during submaximal walking: a link to fatigue improvement following a physical activity intervention among breast cancer survivors. J Cancer Surviv 10, 927–934 (2016). https://doi.org/10.1007/s11764-016-0539-2

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  • DOI: https://doi.org/10.1007/s11764-016-0539-2

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