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A Real-World High-Intensity Interval Training Protocol for Cardiorespiratory Fitness Improvement

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Cardiorespiratory Fitness, Functional Fitness and Body Composition Among Breast Cancer Survivors With 8 Weeks of

Lauren Struszczak^1,2, Jean-Philippe Walhin¹, James Betts¹

¹Centre for Nutrition, Exercise and Metabolism, Department for Health, University of Bath, Bath, UK.

Cancer Medicine

|February 8, 2026

Abstract

Background:

This randomised, controlled non-inferiority trial investigated whether 8 weeks of remotely-supported exercise training changes cardiorespiratory fitness, functional fitness and body composition by a magnitude that is not meaningfully inferior to changes caused by partly-supervised exercise training.

Methods:

Thirty female breast cancer survivors (57 ± 6 years, $\dot{V} O_{2} \max$ 28.9 ± 6.1 mL·kg^-1·min^-1, BMI 25.3 ± 3.3 kg·m^-2) were randomised to 8 weeks of partly-supervised (n = 15) or remotely-supported (n = 15) exercise training. The partly-supervised group undertook two supervised and one unsupervised session per week, progressing from 55% to 70% $\dot{V} O_{2} \max$ and 35-50 min. The remotely-supported group were prescribed the same total duration of exercise per week (progressing from 105 to 150 min). Intensity was prescribed using heart rate targets corresponding to 55%-70% $\dot{V} O_{2} \max$ . $\dot{V} O_{2} \max$ , functional fitness, body composition and blood pressure were assessed pre- and post-intervention.

Results:

Adherence was higher in the partly-supervised group (87% ± 7%) versus the remotely-supported group (64% ± 25%; p = 0.01). The remotely-supported group exhibited changes in timed up and go (difference to partly-supervised; 95% CI -0.8 to 0.4 s) and percentage body fat (difference to partly-supervised; 95% CI -0.6 to 0.5 kg·m^-2) that were non-inferior to the partly-supervised group. It was inconclusive whether changes among the remotely-supported group for $\dot{V} O_{2} \max$ (difference to partly-supervised; 95% CI -3.3 to 1.1 mL·kg^-1·min^-1), blood pressure (difference to partly-supervised; 95% CI systolic; -3 to 12 mmHg, diastolic; -5 to 6 mmHg), 6 min walk (difference to partly-supervised; 95% CI -54.0 to 0.4 m), or sit to stand (difference to partly-supervised; 95% CI -3 to 2 repetitions), were non-inferior to the partly-supervised group.

Conclusion:

Remotely-supported exercise might be an alternative to partly-supervised exercise regarding functional fitness (assessed by timed up and go) and body composition (assessed by percentage body fat). It remains inconclusive whether remotely-supported exercise is an alternative regarding $\dot{V} O_{2} \max$ , blood pressure and other functional fitness measurements (6-min walk, sit to stand).

Trials Registration:

NCT06376578 (20/11/2020).

Keywords:

breast cancer survivors exercise fitness health

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