Abstract P4-06-25: The impact of multimodal exercise program on physical and functional outcomes in breast cancer survivors: A randomized controlled trial

Abstract Introduction: Despite there are considerable number and variety of physical exercise programs having demonstrated benefits in breast cancer patients (BCP), exist certain factors such as the lack of awareness and difficulty in accessing oncology exercise programs and the scarcity of qualified professionals in this field difficulted the adherence of the breast cancer survivors to the exercise recommendations by the World Health Organization (WHO). This study aimed to evaluate the impact of a multimodal oncological exercise program on these parameters in breast cancer patients at stages IA to IIIB. Methodology: Patients contacted the research team to schedule baseline assessments at Centro Ejercicio Y Cáncer, in Madrid. Inclusion criteria for participation were women diagnosed with primary breast cancer (stages IA to IIIB); aged 18 years or older; no more than 10 years since cancer diagnosis; and without other comorbidities that would limit their capacity to engage in exercise (recent surgery or functional limitations) were included in this study. Patients with metastatic disease, undergoing chemotherapy and radiotherapy were excluded from the study. Afterward, all women were randomly assigned to one of the two groups. The intervention comprised a multimodal exercise program (online and face-to-face) for 16 weeks that included endurance, resistance, balance, and proprioception exercises, with an intensity ranging from 55% to 95% of Heart Rate Reserve (HRR). Each session lasted 75 minutes and was structured as follows: 10 minutes of warm-up involving joint mobilities, balance, and proprioceptive exercises, and aerobic exercise at an intensity ranging from 55% to 75% HRR. This was followed by two 20-minute bouts of combined activities (endurance activities combined with resistance exercises) at an average intensity of 70-75% HRR with 30 to 60-second bouts of high-intensity activity of 85% to 100% HRR. The resistance exercises were developed with free weights in circuits of 6 to 8 exercises of 3x10 or 3x15, combined with endurance activities of 60% HRR. Intensity perception in resistance exercises was assessed using the Borg Scale, and endurance exercise intensity was assessed by HRR. Finally, full-body stretching was performed. Results: 40 patients in the intervention group (mean 50.2±1.05 years old) and 34 in the control group (mean 49.48±1.88 years old) completed the study. Related to the program adherence was 95.23% in the intervention group and 82.93% in the control group, and the assistance rate was 85.13%. BCP in the intervention group showed significant improvements in cardiorespiratory fitness (DifMean (ΔM): 7.19 ml.kg.min; CI95% 4.50 – 9.60; p=<0.0001); fat mass (ΔM: -1.81%; CI95% -3.47 - -0.15; p=0.033); lean mass (ΔM: 5.24%; CI95% 3.74 – 6.74; p=<0.0001); functional capacity through sit -to-stand (ΔM: 5.26 number of repetitions; CI95% 2.01 – 5.26; p=0.002) and 6-minutes walking test (ΔM: 89.58 meters; CI95% 36.78 – 142.37; p=0.001); level of PA such us total METs (ΔM: 946.85 METs (min/week); CI95% 212.08 - 1681.64; p=0.012) and high intensity METs (ΔM: 419.65 METs (min/week); CI95% 37.93 - 801.36; p=0.032); Fatigue (ΔM: -3.20; CI95% -5.75 - -0.65; p=0.014). Conclusions: This RCT has demonstrated a multimodal exercise program is feasible and effective in significantly improving cardiorespiratory fitness, body composition, and physical function in BCP. The implementation of these new models of exercise interventions not only allows BCPs to access supervised exercise programs but also, presents high levels of adherence. These findings advocate for integrating structured exercise programs into the treatment plan for breast cancer patients, with potential long-term benefits for survival and quality of life. Citation Format: Soraya Casla-Barrio, Mónica Castellanos-Montealegre, Helios Pareja, Laura Cantero. The impact of multimodal exercise program on physical and functional outcomes in breast cancer survivors: A randomized controlled trial [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P4-06-25.