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?ObjectiveTo 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.DesignA prospective study in which exercise testing was performed before and after training intervention.SettingAcademic and general hospital and rehabilitation center.ParticipantsCancer survivors (N=147) (all cancer types, medical treatment completed ≥3mo ago) attended a 12-week supervised exercise program.InterventionsA 12-week training program including aerobic training, strength training, and group sport.Main Outcome MeasuresOutcome 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).ResultsThe 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.ConclusionsFor 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.