Lower Rate-pressure Product During Submaximal Walking Is Associated With Fatigue Improvement Among Breast Cancer Survivors
Bibliographic record
Abstract
PURPOSE: Research linking exercise-induced changes in aerobic fitness and reduced fatigue after cancer diagnosis has been inconsistent. We evaluated the association between rate-pressure product (RPP), a reliable index of myocardial oxygen demand, and fatigue response to a physical activity intervention among post-primary treatment breast cancer survivors (BCS). METHODS: Post-hoc analyses of 152 BCS in a randomized controlled trial testing a physical activity intervention (INT) versus usual care (UC) were performed. The INT group completed counseling/group discussions along with supervised exercise sessions tapered to unsupervised workouts. Evaluations were made at baseline and immediately post-intervention at month 3 (M3) on measures of physical activity (accelerometry), a graded-exercise test, and average fatigue over the previous 7 days. RPP was calculated by dividing the product of heart rate and systolic blood pressure by 100 at rest and during submaximal walking using the Naughton protocol. RESULTS: The magnitude of change ([INCREMENT]) in resting and submaximal RPPs at M3 were greater in the INT group from stage 1 (1 mph; 0% grade) ([INCREMENT]RPP1; INT −13 ± 17 vs. UC −7 ± 18; p = 0.03) through stage 4 (2 mph; 7% grade) ([INCREMENT]RPP4; INT −21 ± 26 vs. UC −9 ± 24; p < 0.01) of the walk test. The INT group reported significantly reduced fatigue at M3 (INT −0.7 ± 2.0 vs. UC +0.1 ± 2.0; p = 0.02); [INCREMENT]fatigue was positively associated with [INCREMENT]RPP during stages 2–4 of the walk test but not [INCREMENT]aerobic fitness. Path analyses revealed a significant indirect effect of group randomization on [INCREMENT]fatigue through [INCREMENT]RPP4, β = −0.167, 95% CI [−0.46, −0.06]. The full model including group randomization and [INCREMENT]RPP4 as predictors accounted for 25% of the total variance in [INCREMENT]fatigue. CONCLUSIONS: Lower RPP during submaximal walking was significantly associated with reduced fatigue among BCS. Exercise/physical activity training programs that lower the physiological strain during submaximal walking may produce the largest improvements in reported fatigue. Further research concerning the role of autonomic function and the cardiovascular system (contributors to RPP) in mediating exercise training effects on fatigue in BCS is needed. NIH R01CA136859 (Rogers), R01DK049779 (Hunter), & P30DK056336 (Carter). Kerry S. Courneya is supported by the Canada Research Chairs Program.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".