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Cardiorespiratory and neuromuscular deconditioning in fatigued and non-fatigued breast cancer survivors

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Abstract

Purpose

Fatigue is one of the most commonly reported side effects during treatment for breast cancer and can persist following treatment completion. Cancer-related fatigue after treatment is multifactorial in nature, and one hypothesized mechanism is cardiorespiratory and neuromuscular deconditioning. The purpose of this study was to compare cardiorespiratory and neuromuscular function in breast cancer survivors who had completed treatment and met the specified criteria for cancer-related fatigue and a control group of breast cancer survivors without fatigue.

Methods

Participants in the fatigue (n = 16) and control group (n = 11) performed a maximal exercise test on a cycle ergometer for determination of peak power, power at lactate threshold, and VO2 peak. Neuromuscular fatigue was induced with a sustained submaximal contraction of the right quadriceps. Central fatigue (failure of voluntary activation) was evaluated using twitch interpolation, and peripheral fatigue was measured with an electrically evoked twitch.

Results

Power at lactate threshold was lower in the fatigue group (p = 0.05). There were no differences between groups for power at lactate threshold as percentage of peak power (p = 0.10) or absolute or relative VO2 peak (p = 0.08 and 0.33, respectively). When adjusted for age, the fatigue group had a lower power at lactate threshold (p = 0.02) and absolute VO2 peak (p = 0.03). There were no differences between groups in change in any neuromuscular parameters after the muscle-fatiguing protocol.

Conclusions

Findings support the hypothesis that cardiorespiratory deconditioning may play a role in the development and persistence of cancer-related fatigue following treatment. Future research into the use of exercise training to reduce cardiorespiratory deconditioning as a treatment for cancer-related fatigue is warranted to confirm these preliminary findings.

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Acknowledgements

We wish to thank Cheryl So for her assistance with data collection and Tanya Ivanova for her assistance with the Biodex equipment and data collection. We would also like to thank the participants their time in participating in this study.

Funding

SN was supported by a Canada Graduate Student Scholarship Master’s Award from Canadian Institutes of Health Research; infrastructure support by Canadian Breast Cancer Foundation BC/Yukon and Canadian Cancer Society BC/Yukon was given to KC.

Conflict of interest

The authors declare they have no conflict of interest to report.

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Authors and Affiliations

  1. Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC, Canada, V6T 1Z3

    Sarah E. Neil, S. Jayne Garland & Kristin L. Campbell

  2. School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada, V6T 1Z3

    Sarah E. Neil

  3. Cancer Survivor Center, 1450 Crystal Lake Road, Aspen, CO, 81611, USA

    Riggs J. Klika

  4. School of Kinesiology, University of British Columbia, 210-6081 University Blvd, Vancouver, BC, Canada, V6T 1Z1

    Donald C. McKenzie

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  1. Sarah E. Neil
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  5. Kristin L. Campbell
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Correspondence to Kristin L. Campbell.

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Neil, S.E., Klika, R.J., Garland, S.J. et al. Cardiorespiratory and neuromuscular deconditioning in fatigued and non-fatigued breast cancer survivors. Support Care Cancer 21, 873–881 (2013). https://doi.org/10.1007/s00520-012-1600-y

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