title: Exercise training intensity prescription in breast cancer survivors: validity of current practice and specific recommendations.
abstract: OBJECTIVE
  Cancer survivors are recommended to perform 150 min/week of moderate or 75 min/week of vigorous aerobic exercise, but it remains unclear how moderate and vigorous intensities can be prescribed. Therefore, it was investigated whether and how intensity prescriptions for healthy adults by the American College of Sports Medicine (ACSM) need to be adapted for breast cancer survivors.
  
  
  METHODS
  Fifty-two breast cancer survivors (stage 0-III, age 52 ± 9 years, BMI 25.4 ± 3.5 kg/m2) performed cardiopulmonary exercise tests at the end of primary therapy. Intensity classes defined as percentages of maximal heart rate (HRmax), heart rate reserve (HRR), and maximal oxygen uptake (VO2max) were compared to the ACSM's intensity classes using oxygen uptake reserve as reference.
  
  
  RESULTS
  The prescriptions for moderate and vigorous exercise intensities were significantly different between breast cancer survivors and healthy adults when using VO2max (moderate 50-66 vs. 46-63 and vigorous 67-91 vs. 64-90% VO2max) or HRR (moderate 26-50 vs. 40-59 and vigorous 51-88 vs. 60-89 % HRR), but not when using HRmax (moderate 65-76 vs. 64-76 and vigorous 77-94 vs. 77-95% HRmax).
  
  
  CONCLUSIONS
  In breast cancer survivors, intensity prescriptions for healthy adults result in considerably too intense training if HRR is used as guiding factor. Prescriptions using VO2max result in a slightly too low exercise intensity, whereas recommendations in percentages of HRmax appear valid.
  
  
  CONCLUSIONS
  Cancer survivors should not uncritically adopt exercise intensity prescriptions for healthy adults. Specific prescriptions for the studied population are provided.
authors.affiliation: Department of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany. friederike.scharhag-rosenberger@nct-heidelberg.de.|Department of Preventive Oncology, National Center for Tumor Diseases (NCT) Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany. friederike.scharhag-rosenberger@nct-heidelberg.de.
authors.forename: Friederike
authors.initials: F
authors.lastname: Scharhag-Rosenberger
authors.affiliation: Department of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany.|Department of Preventive Oncology, National Center for Tumor Diseases (NCT) Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Rea
authors.initials: R
authors.lastname: Kuehl
authors.affiliation: Department of Preventive Oncology, National Center for Tumor Diseases (NCT) Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Klassen
authors.affiliation: First Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: Schommer
authors.affiliation: Department of Preventive Oncology, National Center for Tumor Diseases (NCT) Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Martina E
authors.initials: ME
authors.lastname: Schmidt
authors.affiliation: Department of Preventive Oncology, National Center for Tumor Diseases (NCT) Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany.|Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA.
authors.forename: Cornelia M
authors.initials: CM
authors.lastname: Ulrich
authors.affiliation: Department of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany.|Department of Preventive Oncology, National Center for Tumor Diseases (NCT) Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Wiskemann
authors.affiliation: Department of Preventive Oncology, National Center for Tumor Diseases (NCT) Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Karen
authors.initials: K
authors.lastname: Steindorf
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality / Q000534:rehabilitation*; D015444:Exercise / Q000502:physiology; D005080:Exercise Test; D005081:Exercise Therapy / Q000145:classification / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008875:Middle Aged; D005082:Physical Exertion / Q000502:physiology; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards*; D017741:Survivors / Q000706:statistics & numerical data
keywords: Aerobic exercise; Aerobic training; Cancer patients; Endurance training; Physical activity; Supportive therapy