Monitoring Training Progress During Exercise Training in Cancer Survivors: A Submaximal Exercise Test as an Alternative for a Maximal Exercise Test?

May AM, van Weert E, Korstjens I, Hoekstra-Weebers JE, van der Schans CP, Zonderland ML, Mesters I, van den Borne B, Ros WJ. Monitoring training progress during exercise training in cancer survivors: a submaximal exercise test as an alternative for a maximal exercise test? Objective: To examine the use of a submaximal exercise test in detecting change in fitness level after a physical training program, and to investigate the correlation of outcomes as measured submaximally or maximally. Design: A prospective study in which exercise testing was performed before and after training intervention. Setting: Academic and general hospital and rehabilitation center. Participants: Cancer survivors (N=147) (all cancer types, medical treatment completed ≥3mo ago) attended a 12-week supervised exercise program. Interventions: A 12-week training program including aerobic training, strength training, and group sport. Main Outcome Measures: Outcome measures were changes in peak oxygen uptake (Vo2peak) and peak power output (both determined during exhaustive exercise testing) and submaximal heart rate (determined during submaximal testing at a fixed workload). Results: The Vo2peak and peak power output increased and the submaximal heart rate decreased significantly from baseline to postintervention (P<.001). Changes in submaximal heart rate were only weakly correlated with changes in Vo2peak and peak power output. Comparing the participants performing submaximal testing with a heart rate less than 140 beats per minute (bpm) versus the participants achieving a heart rate of 140bpm or higher showed that changes in submaximal heart rate in the group cycling with moderate to high intensity (ie, heart rate ≥140bpm) were clearly related to changes in VO2peak and peak power output. Conclusions: For the monitoring of training progress in daily clinical practice, changes in heart rate at a fixed submaximal workload that requires a heart rate greater than 140bpm may serve as an alternative to an exhaustive exercise test.

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