Optimising prescription for metastatic breast cancer patients through a three-level submaximal exercise test protocol

Abstract

Purpose: Exercise prescription in metastatic breast cancer (MBC) requires individualised assessment to maximise effectiveness and safety. This study examined feasibility of a three-level submaximal exercise test protocol to assess physical capacity in MBC. Materials and Methods: This cross-sectional study (N = 70) assessed physical capacity in women with MBC using a multi-stage treadmill test, 30-second sit-to-stand (30STS), and a 120-second adapted burpees test, performed consecutively if progression criteria were met. Heart rate (HR) and rating of perceived exertion (RPE) were recorded. Secondary outcomes included cancer-related fatigue (CRF) and upper- and lower-limb functionality (ULFI and LLFI). Results: Sixty-four participants completed the multi-stage treadmill test, 70 completed the 30STS, and 5 (those meeting progression criteria) performed adapted burpees. HR and RPE increased progressively with exercise intensity, with highest values during adapted burpees. Women reported low-to-moderate levels of CRF (mean PFS-R: 4.5, standard deviation [SD]: 2.5) and moderate-to-high upper- and lower-limb functionality (mean ULFI: 70.8%, SD: 20.3; LLFI: 68.4%,SD: 26.4). Conclusion: Multi-level physical capacity testing appears feasible in MBC, particularly at submaximal levels, although higher-intensity tests may be limited to a small subset when using progression criteria and highlight importance of individualisation. Incorporating self-reported measures may enhance the comprehensive evaluation of patient function and limitations.