Monitoring training progress during exercise training in cancer survivors: a submaximal exercise test as an alternative for a maximal exercise test?

OBJECTIVE: To 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.

DESIGN: A prospective study in which exercise testing was performed before and after training intervention.

SETTING: Academic and general hospital and rehabilitation center.

PARTICIPANTS: Cancer survivors (N=147) (all cancer types, medical treatment completed > or =3 mo ago) attended a 12-week supervised exercise program.

INTERVENTIONS: A 12-week training program including aerobic training, strength training, and group sport.

MAIN OUTCOME MEASURES: Outcome measures were changes in peak oxygen uptake (Vo(2)peak) and peak power output (both determined during exhaustive exercise testing) and submaximal heart rate (determined during submaximal testing at a fixed workload).

RESULTS: The Vo(2)peak 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 Vo(2)peak 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 140 bpm or higher showed that changes in submaximal heart rate in the group cycling with moderate to high intensity (ie, heart rate > or =140 bpm) were clearly related to changes in VO(2)peak and peak power output.

CONCLUSIONS: For 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 140 bpm may serve as an alternative to an exhaustive exercise test.