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Comparison of Aerobic Exercise Intensity Prescription Methods in Breast Cancer


Medicine & Science in Sports & Exercise: August 2013 - Volume 45 - Issue 8 - p 1443–1450
doi: 10.1249/MSS.0b013e3182895195
Clinical Sciences

Introduction Exercise plays an important role in cancer rehabilitation, but a precise prescription of exercise intensity is required to maximize the benefits of this intervention. It is unknown whether different methods of prescribing aerobic exercise intensity achieve the same intensity. Breast cancer treatments may alter exercise response and thereby may affect the accuracy of these methods.

Purpose The purpose of this study was to compare the accuracy and achieved intensity of four common methods of prescribing exercise intensity within and between breast cancer patients recently finished chemotherapy (n = 10), survivors finished treatment (n = 10), and healthy controls (n = 10).

Methods The methods compared were as follows: the American College of Sports Medicine’s metabolic equation for treadmill walking (METW), heart rate reserve (HRR), direct heart rate (DIRECT HR), and RPE. The methods were used to prescribe 60% oxygen consumption reserve (V˙O2R) in four randomly assigned 10-min periods of treadmill walking with expired gas collection to evaluate 1) achieved intensity (measured % V˙O2R) and 2) accuracy (defined as: [60% V˙O2R–achieved intensity]).

Results The accuracy of the methods was not equivalent across groups (P = 0.04). HRR and METW did not differ across groups and were most accurate in patients. HRR, METW, and DIRECT HR were all more accurate than RPE in survivors (P ≤ 0.01). RPE was the least accurate in all groups. The accuracy of DIRECT HR was much lower in patients than that in survivors and controls (P ≤ 0.01).

Conclusions The four methods of exercise intensity prescription varied in accuracy in prescribing 60% V˙O2R and did not achieve equivalent exercise intensities within breast cancer patients, survivors, and healthy controls. HRR and METW were the most accurate methods for exercise intensity prescription in breast cancer patients and survivors.

1School of Kinesiology, University of British Columbia, Vancouver, BC, CANADA; 2Department of Physical Therapy, University of British Columbia, Vancouver, BC, CANADA; and 3Division of Sports Medicine, Department of Family Practice, University of British Columbia, Vancouver, BC, CANADA

Address for correspondence: Donald C. McKenzie, M.D., Ph.D., School ofKinesiology, University of British Columbia, 3055 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada; E-mail:

Submitted for publication September 2012.

Accepted for publication January 2013.

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© 2013 American College of Sports Medicine