{"paper_id":"106d29a7-17ff-453c-b535-4bd6bea0d99a","body_text":"The effects of resistance training vs high intensity interval training on body composition, muscle strength, cardiorespiratory fitness, and quality of life in survivors of breast cancer: a randomized trial | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The effects of resistance training vs high intensity interval training on body composition, muscle strength, cardiorespiratory fitness, and quality of life in survivors of breast cancer: a randomized trial Francesco Bettariga, Dennis R. Taaffe, Cristina Crespo Garcia, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5191258/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 18 Nov, 2024 Read the published version in Breast Cancer Research and Treatment → Version 1 posted 7 You are reading this latest preprint version Abstract Purpose. Breast cancer treatments often lead to unfavourable changes in body composition, physical fitness, and quality of life (QoL). We compared the effects of resistance training (RT) and high-intensity interval training (HIIT) on these outcomes in survivors of breast cancer. Methods. Twenty-eight survivors of breast cancer, post-treatment (Stage I-III), aged 55.5 ± 8.8 years and body mass index 27.9 ± 5 kg/m 2 were randomly allocated to a 12-week supervised RT or HIIT intervention, 3 days per week. Body composition, upper and lower body muscle strength, cardiorespiratory fitness (CRF), and QoL domains were assessed at baseline and 12 weeks. Results. There were no significant differences at baseline between groups. Exercise attendance ranged from 81 to 85%. After 12 weeks, lean mass increased in the RT (mean difference [MD] = 0.6 kg, p = 0.049), while % fat mass decreased in the HIIT (MD = -0.6%, p = 0.039), with no significant differences between groups. Between-groups there were significant differences ( p < 0.001) with improvement in chest press strength for RT (MD = 4.7 kg) and CRF for HIIT (MD = 1.9 ml/min/kg). There were significant within-group improvements ( p < 0.001) in muscle strength and CRF for both RT and HIIT. QoL (global health, function, and symptoms) significantly improved ( p < 0.05) in both groups, without any difference between groups. No major adverse events were noted. Conclusion. Both exercise groups improved body composition, physical fitness, and QoL domains over 12 weeks of RT or HIIT, although mode-specific benefits were apparent with more substantial improvements in lean mass and muscle strength with RT and reductions in % fat mass and improved CRF with HIIT. Tailored exercise programs should address the specific health needs of each patient. breast cancer resistance training high intensity interval training body composition physical fitness Figures Figure 1 1. Introduction Breast cancer is a significant global health challenge, contributing to high morbidity and mortality [ 1 ]. In 2022, there were 2.3 million new breast cancer cases and 660,000 breast cancer deaths worldwide, making breast cancer the most diagnosed and the leading cause of cancer-related death in women [ 1 ]. Breast cancer treatments, particularly chemotherapy, ovarian function suppression and endocrine therapy, are associated with a range of adverse effects, including not only an increase in body weight, but also loss of lean mass (LM) and increase in fat mass (FM) [ 2 – 6 ]. Such alterations are relevant as body composition components are associated with breast cancer-specific mortality [ 7 – 9 ]. This association may be due to the critical role that skeletal muscle and adipose tissue play as secretory organs with the release of hormones (e.g., insulin) and cytokines (e.g., interleukin 6) [ 10 – 12 ]. These hormones and cytokines have effects on metabolism, inflammation, the immune system, and tumorigenesis [ 12 – 14 ]. However, in the state of excessive adipose tissue and/or lowered skeletal muscle mass, their functions may be disrupted and out of balance leading to alterations in circulating factors [ 12 ]. In addition, breast cancer and the related treatments lead to reduced muscle strength and cardiorespiratory fitness (CRF) [ 15 – 17 ], which are predictors of all-cause mortality in patients with cancer [ 18 , 19 ]. Furthermore, such alterations in body composition and physical fitness, along with cancer-related fatigue, anxiety, depression, and pain, commonly observed in breast cancer survivors lead to reduced quality of life (QoL) [ 20 – 22 ]. Exercise is acknowledged as an essential therapeutic strategy in cancer management [ 23 – 26 ]. A robust body of evidence supports exercise to be safe and effective during or post-cancer treatment to improve various health outcomes. More importantly exercise is also associated with a 40% reduced risk of recurrence and longer survival [ 23 – 27 ]. Moreover, it is well known that long-term exercise programs reduce body weight and FM and improve LM in breast cancer survivors, especially when coupled with dietary intervention [ 28 – 30 ]. Such alterations in body composition induced by exercise are relevant not only for improvements in physical and psychological outcomes, but also for their effects on circulating factors that may affect disease progression [ 14 , 31 – 34 ]. Appropriately targeted exercise programs not only enhance muscle strength and CRF levels in breast cancer survivors, but also improve cancer-related fatigue, anxiety, depression, and pain, leading to enhanced QoL [ 35 – 38 ]. When considering the type of exercise undertaken, two distinct modes have commonly been used: resistance training (RT) and aerobic training (AT), the latter of which can generally be performed as moderate intensity continuous training (MICT) or high intensity interval training (HIIT) [ 25 ]. HIIT is a time efficient form of training and in clinical populations (e.g., CVD, diabetes, obesity) including those with cancer, HIIT has been shown to result in greater CRF benefits compared to MICT, and to reduce FM [ 39 – 42 ]. To date, and in line with current guidelines, the majority of exercise trials in breast cancer survivors have utilised combined RT and AT [ 25 ]; however, no studies have been conducted comparing RT vs HIIT as sole exercise modes in breast cancer survivors. Characterizing specific changes induced by each exercise mode in breast cancer survivors would aid in more precise application of exercise medicine. Therefore, the aim of this study was to examine the effects of a 12-week supervised RT vs HIIT intervention on body composition, muscle strength, CRF, and QoL. Our hypothesis was that RT would be superior to HIIT for enhancing muscle strength and LM while HIIT would be superior for improving CRF and decreasing FM. 2. Methods This was a two-arm randomized trial comparing a 12-week RT vs HIIT intervention on body composition, muscle strength, CRF, and QoL in breast cancer survivors. Ethical approval was obtained from the Edith Cowan University Human Research Ethics Committee (ID: 2023-04617-BETTARIGA) and the trial was registered on ANZCTR (ID: ACTRN12624000820505). 2.1. Participants, recruitment, and allocation Eligible participants were: 1) women originally diagnosed with stage I-III breast cancer; 2) with or without endocrine therapy; 3) completed primary treatment (e.g., chemotherapy, radiation therapy, surgery) at least 4 months prior; 4) body mass index (BMI) from 18.5 to 35 kg/m 2 ; 5) medically cleared for exercise; and 6) willing and able to comply with all study requirements, including treatment, timing and/or nature of required assessments. Exclusion criteria were: 1) any known absolute contraindication to exercise; 2) currently completing vigorous exercise in the past 3 months (i.e., AT ≥ 150 or 75 minutes at moderate or high intensity, respectively, or RT ≥ 2 sessions per week); 3) life expectancy < 12 months; and 4) pregnant or lactating. Additionally, participants were required to maintain their habitual diet throughout the exercise training intervention. Recruitment occurred between 1st October 2023 and 1st July 2024 at the Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia. All participants were informed as to the purpose of the study and written informed consent was obtained before commencement of the study. Participants were randomly assigned using a digital software program to RT or HIIT in a ratio of 1:1. 2.2. Outcome measures 2.2.1. Body composition Whole body LM and FM in kg, appendicular lean mass (ALM) in kg/m 2 , lean mass percentage (LM%) and body fat percentage (FM%), as well as visceral adipose tissue mass (VAT) in grams were assessed using dual-energy x-ray absorptiometry (DXA; Horizon A, Hologic, Washington, USA) [ 43 ]. ALM was calculated as the sum of upper limb and lower limb bone-free lean mass. 2.2.2. Muscle strength and cardiorespiratory fitness Chest press and leg press muscle strength were assessed using the 1-repetition maximum (1RM) test [ 44 ]. The 1RM is the maximum resistance that can be moved through a full range of motion, maintaining the correct body position and technique [ 44 ]. All participants were familiarized with the testing procedures and 1RM was determined when participants could perform only 1 repetition at a given resistance. For cardiorespiratory fitness, maximal oxygen uptake (VO2max) was assessed using the sub-maximal Ekblom-Bak test on a cycle ergometer pedalling at 60 RPM [ 45 , 46 ]. All participants were familiarized with testing procedures and Borg’s 6 to 20 rating of perceived exertion (RPE) scale [ 47 ]. The test included 2 x 4-minute sub-maximal bouts, starting with 0.5 kilopond and individually increased based on RPE. Heart rate was collected electronically and a computer program was used to predict VO2max [ 46 ]. Muscle strength and CRF tests were conducted on separate days and participants were required to avoid any strenuous activity at least 48 hours before the test with a 72-hour rest period between the final exercise session and post-intervention testing. 2.2.3. Quality of life The European Organization for Research and Treatment of Cancer questionnaires, EORTC QLQ-C30 and EORTC QLQ-BR45, were administered to all participants to evaluate global health, function, and symptom domains [ 48 , 49 ]. The domains of function in the QLQ-C30 and BR45 include different items, such as physical, role, emotional, cognitive, social, and sexual functioning, whilst the domains of symptoms in the QLQ-C30 and BR45 encompass fatigue, nausea, pain, dyspnoea, insomnia, appetite loss, breast symptoms, and financial difficulties. The sum of each item led to the summary score for that domain. For global health and function, higher scores indicate higher QoL and functioning, whilst for symptoms lower scores indicate lower symptomatology. 2.3. Exercise intervention Participants exercised 3 days per week for 12 weeks under supervision. Each exercise session lasted approximately 60 min, including warm-up and cool-down. Participants allocated to RT performed 8 to 12 repetitions for 3 to 5 sets of major muscle group exercises, including chest press, seated row, shoulder press, lat pulldown, leg press, leg extension, leg curl, and lunges (Supplementary Table 1). Intensity was adjusted according to participants’ tolerance in order to achieve an RPE of 5 to 9 (using the 1 to 10 RPE scale [ 50 ]) or 60 to 80% 1RM [ 51 , 52 ]. A 60- to 120-second rest period was provided between sets. For time efficiency and to minimize fatigue, exercises were alternated between the upper and lower body (e.g., chest press then leg press). Participants allocated to HIIT performed 5 to 7 bouts of 30 seconds at high intensity, with active recovery ranging from 30 to 60 seconds, for 4 to 6 sets on a stationary cycle, treadmill, rower, or cross-trainer (Supplementary Table 2). Intensity was adjusted according to participants’ tolerance in order to achieve an RPE of 5 to 9 (using the 1 to 10 RPE scale [ 53 ]) or 60 to 90% of estimated HRmax (220 – age) for the high intensity bouts. During the active recovery repetitions participants were required to maintain a slow pace at an RPE of ≈ 3. A 180-second rest period was provided between sets. Different work to rest ratio schemes based on bout duration and active recovery were provided. Both RT and HIIT were periodised aiming to increase the exercise load over 12 weeks in a non-linear fashion [ 54 ]. 2.4. Statistical analysis Regarding statistical power, we would consider a difference between groups in our outcomes of interest of 1 SD to be clearly important. To achieve 80% power at an alpha level of 0.05 (two-tailed), 16 participants per group are required for a total of 32 participants. Data were analysed using SPSS (version 25.0; SPSS, Inc., Armonk, NY). Normality of the distribution was assessed using the Shapiro-Wilk test and all data were normally distributed ( p > 0.05). For baseline comparisons, independent t -tests were used for continuous data and Chi-square for categorical variables. Paired sample t -test was used to examine the within-group changes. Group x time repeated measures ANOVA was used to calculate between-group intervention effects on body composition, muscle strength, CRF, and QoL domains. Tests were two-tailed, and a p-value < 0.05 was considered statistically significant. 3. Results Sixty breast cancer survivors were assessed for eligibility, with 32 recruited and randomized to RT or HIIT (Fig. 1 ). Four participants withdrew from the study for family and health reasons not related to the exercise intervention. Baseline characteristics were similar between the two groups, apart from the number of women who received chemotherapy during cancer treatment which was higher in the HIIT group ( p = 0.012) (Table 1 ). Attendance rate was 85% for RT and 81% for HIIT. No major adverse events were reported or observed during the exercise interventions or testing. However, minor adverse events, including muscle soreness and temporary fatigue, were transient and resolved without intervention. BMI and body weight did not significantly change from pre- to post-intervention and no between-group differences were observed. Table 1 Baseline participant characteristics. RT (n = 14) HIIT (n = 14) p-value Age (years) 61.8 ± 8.9 56.9 ± 8.9 0.194 Body weight (kg) 77.7 ± 11.8 78.1 ± 21.1 0.958 Height (cm) 165.7 ± 7.0 168.4 ± 7.1 0.542 BMI (kg/m 2 ) 28.4 ± 4.2 27.5 ± 5.8 0.633 Time since diagnosis (months) 28.6 ± 8.5 34.7 ± 20.3 0.312 Cancer stage (%) 1 50 29 0.228 2 35 42 3 15 29 Undertaking hormone therapy (%) 70 78 0.663 Previous treatments (%) Chemotherapy 50 93 0.012 Radiation therapy 57 64 0.699 Surgery 100 100 1.000 Postmenopausal status (%) 70 64 0.686 Hypertension (%) 28 21 0.663 Ethnicity (%) Non-Hispanic white 70 70 1.000 African-America 14 14 1.000 Asian/Pacific islander 14 14 1.000 Married (%) 70 78 0.663 Completed university (%) 57 28 0.127 Full-time employed (%) 50 35 0.445 Current smoker (%) 0 0 1.000 Current drinker (%) 21 14 0.622 Undertaking other medications (e.g., metformin, vitamin D etc) (%) 43 43 1.000 Legend: RT = resistance training; HIIT = high intensity interval training. 3.1. Body composition There was no difference between groups at baseline for any body composition measure. Within and between-group changes for body composition are shown in Table 2 . When examining the between-group changes, there was a significant effect for time for LM% ( p = 0.002), FM ( p = 0.041), and FM% ( p = 0.003), with no significant group x time interactions for any body composition measure. Table 2 Within and between-group changes in body composition for RT and HIIT groups. RT (n = 14) HIIT (n = 14) Pre Post Within-group changes Pre Post Within-group changes Between-group changes mean ± SD mean ± SD MD 95%CI p-value mean ± SD mean ± SD MD 95%CI p-value MD 95%CI p-value * Lean mass (kg) 42.2 ± 4.9 42.8 ± 4.7 0.6 0.1 to 1.1 0.049 42.1 ± 8.9 42.4 ± 8.7 0.4 -0.5 to 1.1 0.362 0.2 -0.7 to 1.2 0.662 % Lean mass 54.7 ± 3.9 55.3 ± 4.1 0.6 0.1 to 1.1 0.022 54.9 ± 5.8 55.5 ± 5.4 0.6 0.1 to 1.1 0.037 0.1 -0.1 to 0.1 0.897 Appendicular lean/height (kg/m2) 6.4 ± 0.7 6.5 ± 0.7 0.1 -0.1 to 0.2 0.090 6.0 ± 1.0 6.1 ± 0.9 0.1 -0.1 to 0.2 0.434 0.1 -0.1 to 0.2 0.542 Fat mass (kg) 33.3 ± 7.7 32.9 ± 7.7 -0.4 -1.1 to 0.3 0.239 33.9 ± 12.5 33.3 ± 11.9 -0.7 -1.5 to 0.2 0.100 0.3 -1.3 to 0.8 0.588 % Fat mass 42.5 ± 4.2 41.9 ± 4.4 -0.6 -1.2 to -0.1 0.031 42.4 ± 6.1 41.8 ± 5.7 -0.6 -1.1 to -0.1 0.039 0.1 -0.8 to 0.7 0.937 VAT (g) 563.4 ± 277.8 557.4 ± 262.9 -6 -59.2 to 47.2 0.811 497.0 ± 229.5 474.6 ± 217.5 -22.5 -57.1 to 12.2 0.185 16.5 -76.9 to 43.9 0.580 Legend: RT = resistance training; HIIT = high intensity interval training; BMI = body mass index; kg = kilograms; g = grams; SD = standard deviation; MD = mean difference; CI = confidence interval; * = group x time interaction p-values. For RT, significant changes ( p < 0.05) from pre- to post-intervention were observed for LM (mean difference [MD] = 0.6 kg), LM% (MD = 0.6%), and FM% (MD = -0.6%), with no significant change for ALM, FM, or VAT. For HIIT, significant changes ( p < 0.05) from pre- to post-intervention were observed for LM% (MD = 0.6%) and FM% (MD = -0.6%), with no significant change for LM, ALM, FM, or VAT. 3.2. Muscle strength and cardiorespiratory fitness There was no difference between groups at baseline for muscle strength or CRF. Within and between-group changes for physical fitness are shown in Table 3 . When examining the between-group changes, there was a significant group x time interaction for chest press strength ( p = 0.001) with a greater increase in RT, and for VO2max ( p < 0.001) with a greater increase for HIIT. In addition, there was a significant effect for time for leg press strength ( p = 0.001). Table 3 Within and between-group changes in physical fitness and QoL for RT and HIIT groups. RT (n = 14) HIIT (n = 14) Pre Post Within-group changes Pre Post Within-group changes Between-group changes mean ± SD mean ± SD MD 95%CI p-value mean ± SD mean ± SD MD 95%CI p-value MD 95%CI p-value * STR - Chest press (kg) 19.9 ± 6.2 27.8 ± 6.7 7.9 5.5 to 10.3 < 0.001 22.7 ± 6.6 25.9 ± 7.2 3.2 1.6 to 4.7 0.001 4.7 1.9 to 7.4 0.001 STR - Leg press (kg) 66.1 ± 28.7 90.2 ± 28.3 24.1 14.9 to 33.2 < 0.001 82.2 ± 18.8 98.3 ± 18.7 16.1 13.4 to 18.8 < 0.001 8.0 -1.1 to 17.1 0.083 CRF (ml/min/kg) 24.4 ± 3.9 25.3 ± 4.1 0.9 0.5 to 1.32 0.001 25.9 ± 3.8 28.7 ± 4.7 2.8 1.9 to 3.6 < 0.001 1.9 1.0 to 2.8 < 0.001 QLQ-C30 - Global health 9.6 ± 2.5 11.0 ± 1.8 1.4 0.1 to 2.7 0.033 10.3 ± 1.6 11.6 ± 1.8 1.2 0.2 to 2.2 0.018 0.2 -1.3 to 1.7 0.777 QLQ-C30 - Function 22.6 ± 4.1 23.9 ± 3.1 1.3 0.9 to 3.5 0.231 19.5 ± 2.3 22.5 ± 3.2 3.0 1.3 to 4.7 0.002 1.7 -0.9 to 4.3 0.193 QLQ-C30 - Symptoms 22.0 ± 4.8 19.1 ± 3.4 -2.9 -4.8 to 1.1 0.006 20.8 ± 3.0 19.9 ± 3.5 -0.9 -2.5 to 0.8 0.290 2.1 -0.3 to 4.5 0.090 QLQ-BR45 - Function 23.0 ± 5.8 25.1 ± 5.4 2.1 0.5 to 3.7 0.016 25.0 ± 5.4 26.8 ± 5.2 1.8 0.1 to 3.6 0.048 0.3 -1.99 to 2.5 0.798 QLQ-BR45 - Symptoms 54.7 ± 10.3 48.1 ± 8.5 -6.6 -10.5 to -2.8 0.002 55.4 ± 11.2 51.3 ± 9.8 -4.1 -7.4 to -0.8 0.019 2.5 -2.2 to 7.3 0.281 Legend: RT = resistance training; HIIT = high intensity interval training; STR = strength; CP = chest press; LP = leg press; CRF = cardiorespiratory function; kg = kilograms; SD = standard deviation; MD = mean difference; CI = confidence interval; * = group x time interaction p-values. For RT, significant improvements ( p < 0.001) from pre- to post-intervention were observed for chest press (MD = 7.9 kg) and leg press (MD = 24.1 kg) strength, and VO2max (MD = 0.9 ml/min/kg). For HIIT, significant improvements ( p < 0.001) from pre- to post-intervention were observed for chest press (MD = 3.2 kg) and leg press (MD = 16.1 kg) strength, and VO2max (MD = 2.8 ml/min/kg). 3.3. Quality of life There was no difference between groups at baseline for any QoL measure. Within and between-group changes for QoL are shown in Table 3 . When examining the between-group changes, there was a significant effect for time for global health ( p = 0.002), function using the QLQ-C30 and BR45 ( p < 0.05), and symptoms using the QLQ-C30 and BR45 ( p < 0.05), with no significant group x time interactions for any QoL domain. For RT, significant improvements ( p < 0.05) from pre- to post-intervention were observed for global health using the QLQ-C30 (MD = 1.4) and function using the QLQ-BR45 (MD = 2.1), as well as reductions in symptoms using the QLQ-C30 (MD = -2.9) and BR45 (MD = -6.6). For HIIT, significant improvements ( p < 0.05) from pre- to post-intervention were observed for global health (MD = 1.2) and function using QLQ-C30 (MD = 3.0) and BR45 (MD = 1.8), as well as reductions in symptoms using the QLQ-BR45 (MD = -4.1). 4. Discussion This study examined the effects of a 12-week supervised RT vs HIIT intervention on body composition, muscle strength, CRF, and QoL in breast cancer survivors. There were three important findings. First, both RT and HIIT improved body composition to a similar extent pre- to post-intervention, without any significant difference between groups. Second, gains in upper and lower body muscle strength significantly favoured the RT group, with gains in CRF favouring the HIIT group. Third, although QoL questionnaires improved to a similar extent regardless of the intervention undertaken by the participants, there were no significant changes in function for participants in the RT group and in symptoms for those in the HIIT group. Breast cancer survivors allocated to RT improved LM, LM%, and FM%, while those allocated to HIIT improved LM% and FM% over the 12-week intervention, although there was no significant difference between the two exercise modes. This corroborates findings from our recent meta-analysis in breast cancer survivors that RT is effective for enhancing LM and HIIT for reducing FM [ 28 ]. Moreover, the magnitude of the changes observed in LM and FM are in line with the current literature in breast cancer survivors, where increases in LM by 0.7 and 0.4 kg and reductions in FM by 0.4 and 1.2 kg accompany isolated RT and AT, respectively [ 28 – 30 ]. Taken together, these changes in body composition, though modest, are of clinical relevance for breast cancer survivors [ 28 ]. Indeed, adverse effects in body composition found after primary treatment are associated with higher disease recurrence and mortality rates [ 7 – 9 ]. However, both RT and HIIT programs were similar in inducing changes in body composition. The absence of between group differences may be attributed to the lack of dietary intervention, which is well known to play a major role in body composition changes in breast cancer survivors [ 55 , 56 ]. In addition, although volume, intensity, and frequency adopted in RT were in line with current guidelines, exercise training programs with longer duration (e.g., 26 weeks) would likely result in greater alterations in body composition [ 25 , 57 ] and potentially greater separation of mode-specific adaptations. In contrast, it is yet to be determined the optimal dose to induce changes in body composition when using a HIIT program [ 58 ]. Despite this, our findings are noteworthy owing to the isolated effects of RT and HIIT observed in our study. Both groups significantly improved upper and lower body muscle strength, with the RT group demonstrating significantly greater strength gains than the HIIT group. Although a significant enhancement of muscle strength was expected after 12 weeks of RT, improvements were also found with HIIT especially for lower body strength as represented by the leg press test. It is well-documented that RT increases muscle strength in patients with breast cancer [ 59 ], but less is known regarding the effects of HIIT on muscle strength [ 58 ]. Although speculative, it appears that the high intensity efforts during HIIT elicit improvement in muscle strength due to the physiological mechanisms induced by interval training, that is, increased firing frequency, enhanced motor unit recruitment and synchronization [ 60 , 61 ]. Despite this, greater muscle strength increases were found after RT, further supporting the superior effects of RT on muscle strength [ 62 , 63 ]. Regarding CRF, both RT and HIIT programs significantly improved VO2max, with the improvement substantially more in the HIIT group. It is well known that HIIT drives substantial improvements in VO2max, leading to augmented CRF in breast cancer survivors [ 58 ]; however, it is yet to be determined to what extent RT can alter VO2max [ 64 ]. The relatively modest effect observed in VO2max could be attributed to local muscle adaptations, particularly in the case of RT, where improvements in oxygen extraction at the muscle level (peripheral adaptations) may have played a more significant role than central cardiovascular changes [ 65 ]. While RT can enhance muscular strength and endurance, its impact on central factors such as cardiac output may be limited compared to HIIT, which targets both peripheral and central adaptations [ 65 ]. Indeed, our findings support that HIIT induces substantial changes in CRF among breast cancer survivors. However, further research is needed to fully elucidate the extent of these changes, especially when comparing the effects of HIIT with MICT [ 58 ]. While initial results are promising, larger and more comprehensive studies are required to establish a clearer understanding of how MICT and HIIT influence CRF outcomes [ 58 ]. Overall, breast cancer survivors completing the exercise training interventions significantly improved QoL, with no significant differences between groups, indicating that both exercise modes were similarly effective. Survivors not only improved global health and QoL aspects related to physical functioning (e.g., role, emotional, and sexual functioning), but also had reduced symptoms (e.g., fatigue, dyspnoea, and insomnia). This is of utmost importance when considering that exercise participation is associated with reduced symptoms and enhanced adherence to prescribed endocrine therapy [ 66 ]. Our results are in line with current evidence indicating exercise to be of benefit in enhancing QoL in breast cancer survivors, even though the specific effects of each exercise mode remain to be fully elucidated [ 35 , 67 ]. In a similar fashion, we have shown in patients with prostate cancer that fatigue and psychological distress are enhanced with various exercise modes [ 68 , 69 ]. Both RT and HIIT programs were safe and feasible with attendance rate classified as high [ 70 ]. To date, lack of enjoyment, fatigue, and boredom have been reported as reasons for low exercise adherence [ 71 ]. The programs employed a non-linear periodization (training variation) structure, which was chosen to maximise exercise adaptations while reducing staleness and fatigue [ 54 ], potentially addressing adherence concerns. The programs were also fully supervised, which is essential with sedentary participants or novice exercisers, ensuring safety and an effective exercise exposure. To the best of our knowledge, this is the first study comparing a RT and HIIT program in breast cancer survivors. The strengths of our study include the supervision, well-defined exercise specifics in terms of volume, intensity, and frequency as well as the > 80% adherence to the exercise intervention. In addition, a wide range of outcomes for body composition, muscle strength, CRF, and QoL, were undertaken providing a comprehensive overview of the impacts of different exercise modes on these outcomes. However, there are some limitations which are worthy of comment. The exercise prescriptions were in line with current guidelines; however, a longer duration (e.g., 26 weeks) would likely be preferrable to investigate changes in the outcomes of interest. In addition, although participants were asked to maintain their habitual lifestyle, dietary records were not undertaken. However, it should be noted that given that there were no substantial changes in body weight, it is unlikely that marked changes in dietary intake patterns occurred in either exercise group during the trial. 5. Conclusion In summary, our findings are that both exercise interventions improved body composition in a similar fashion, with somewhat greater effects observed on LM in RT and a trend towards greater improvement on FM in HIIT. In addition, both RT and HIIT significantly enhanced physical fitness over the 12 weeks, with greater effects on upper body muscle strength with RT and CRF with HIIT. Lastly, QoL domains similarly improved regardless of the intervention. Tailored exercise programs can address health-related outcomes with specific adaptation, highlighting the need of creating exercise training plans that address the health and fitness concerns most relevant to each patient. Declarations Conflict of interest Francesco Bettariga, Dennis R. Taaffe, Cristina Crespo Garcia, Timothy D. Clay, Daniel A. Galvão, and Robert U. Newton declare that they have no conflicts of interest relevant to the content of this study. Funding No funding was received for this project. Author contributions FB drafted the manuscript. FB, CCG, and TC collected data. FB, DT, DG, and RN planned study design. FB, DT, CCG, TC, DG, and RN edited and revised the manuscript. All authors approved the final version before submission. Data availability statement The data that support the findings of this study are available from the corresponding author upon reasonable request. Personal data are securely stored in a restricted-access online system at our institute, ensuring compliance with privacy and data protection regulations. References Bray F et al (2024) Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 74(3):229–263 Anbari AB, Deroche CB, Armer JM (2019) Body mass index trends and quality of life from breast cancer diagnosis through seven years' survivorship. 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Nurs Open 10(4):1954–1965 Meneses-Echávez JF et al (2016) The Effect of Exercise Training on Mediators of Inflammation in Breast Cancer Survivors: A Systematic Review with Meta-analysis. Cancer Epidemiol Biomarkers Prev 25(7):1009–1017 Zhou Y et al (2022) Effects of exercise on inflammatory factors and IGF system in breast cancer survivors: a meta-analysis. BMC Womens Health 22(1):507 Bettariga F et al (2024) Exercise training mode effects on myokine expression in healthy adults: A systematic review with meta-analysis. J Sport Health Sci Joaquim A et al (2022) Impact of physical exercise programs in breast cancer survivors on health-related quality of life, physical fitness, and body composition: Evidence from systematic reviews and meta-analyses. Front Oncol 12:955505 Klassen O et al (2017) Muscle strength in breast cancer patients receiving different treatment regimes. J Cachexia Sarcopenia Muscle 8(2):305–316 Ficarra S et al (2022) Impact of exercise interventions on physical fitness in breast cancer patients and survivors: a systematic review. Breast Cancer 29(3):402–418 Wang TC et al (2023) Differential Impact of Exercises on Quality-of-Life Improvement in Breast Cancer Survivors: A Network Meta-Analysis of Randomized Controlled Trials, vol 15. Cancers (Basel), 13 Türk Y et al (2017) High intensity training in obesity: a Meta-analysis. Obes Sci Pract 3(3):258–271 Ito S (2019) High-intensity interval training for health benefits and care of cardiac diseases - The key to an efficient exercise protocol. World J Cardiol 11(7):171–188 Francois ME, Little JP (2015) Effectiveness and safety of high-intensity interval training in patients with type 2 diabetes. Diabetes Spectr 28(1):39–44 Neuendorf T et al (2023) Effects of high-intensity interval training on functional performance and maximal oxygen uptake in comparison with moderate intensity continuous training in cancer patients: a systematic review and meta-analysis. Support Care Cancer 31(12):643 Glickman SG et al (1985) Validity and reliability of dual-energy X-ray absorptiometry for the assessment of abdominal adiposity. J Appl Physiol 2004. 97(2): pp. 509 – 14 Grgic J et al (2020) Test-Retest Reliability of the One-Repetition Maximum (1RM) Strength Assessment: a Systematic Review. Sports Med Open 6(1):31 Björkman F et al (2016) Validity of the revised Ekblom Bak cycle ergometer test in adults. Eur J Appl Physiol 116(9):1627–1638 Ekblom-Bak E et al (2014) A new submaximal cycle ergometer test for prediction of VO2max. Scand J Med Sci Sports 24(2):319–326 Williams N (2017) The Borg Rating of Perceived Exertion (RPE) scale. Occup Med 67(5):404–405 Kaasa S et al (1995) The EORTC core quality of life questionnaire (QLQ-C30): validity and reliability when analysed with patients treated with palliative radiotherapy. Eur J Cancer 31a:13–14 Bjelic-Radisic V et al (2020) An international update of the EORTC questionnaire for assessing quality of life in breast cancer patients: EORTC QLQ-BR45. Ann Oncol 31(2):283–288 Lea JWD et al (2022) Convergent Validity of Ratings of Perceived Exertion During Resistance Exercise in Healthy Participants: A Systematic Review and Meta-Analysis. Sports Med - Open 8(1):2 Herman L et al (2006) Validity and reliability of the session RPE method for monitoring exercise training intensity. South Afr Sports Med Association, 18 Helms ER et al (2018) RPE vs. Percentage 1RM Loading in Periodized Programs Matched for Sets and Repetitions. Front Physiol 9:247 Svensson P et al (2022) The Borg scale is a sustainable method for prescribing and monitoring self-administered aerobic endurance exercise in patients with chronic kidney disease. Eur J Physiotherapy 25:1–9 Newton RU et al (2018) Intense Exercise for Survival among Men with Metastatic Castrate-Resistant Prostate Cancer (INTERVAL-GAP4): a multicentre, randomised, controlled phase III study protocol. BMJ Open 8(5):e022899 Davies NJ, Batehup L, Thomas R (2011) The role of diet and physical activity in breast, colorectal, and prostate cancer survivorship: a review of the literature. Br J Cancer 105(1):S52–S73 Jia T et al (2022) Association of Healthy Diet and Physical Activity With Breast Cancer: Lifestyle Interventions and Oncology Education. Front Public Health 10:797794 Bellicha A et al (2021) Effect of exercise training on weight loss, body composition changes, and weight maintenance in adults with overweight or obesity: An overview of 12 systematic reviews and 149 studies. Obes Rev 22(S4):e13256 Chen X et al (2023) High-intensity interval training in breast cancer patients: A systematic review and meta-analysis. Cancer Med 12(17):17692–17705 Gerland L, Baumann FT, Niels T (2021) Resistance Exercise for Breast Cancer Patients? Evidence from the Last Decade. Breast Care (Basel) 16(6):657–663 Atakan MM et al (2021) Evidence-Based Effects of High-Intensity Interval Training on Exercise Capacity and Health: A Review with Historical Perspective. Int J Environ Res Public Health, 18(13) Jenkins NDM et al (2021) Increases in motor unit action potential amplitudes are related to muscle hypertrophy following eight weeks of high-intensity exercise training in females. Eur J Sport Sci 21(10):1403–1413 Folland JP, Williams AG (2007) The Adaptations to Strength Training: Morphological and Neurological Contributions to Increased Strength. Sports Med 37:145 Abou Sawan S et al (2023) The Health Benefits of Resistance Exercise: Beyond Hypertrophy and Big Weights. Sport Mov 1(1):e00001Exercise De Backer IC et al (2009) Resistance training in cancer survivors: a systematic review. Int J Sports Med 30(10):703–712 Lekavich CL et al (2021) Aerobic Versus Resistance Training Effects on Ventricular-Arterial Coupling and Vascular Function in the STRRIDE-AT/RT Trial. Front Cardiovasc Med, 8 Sheppard VB et al (2020) Physical activity, health-related quality of life, and adjuvant endocrine therapy-related symptoms in women with hormone receptor-positive breast cancer. Cancer 126(17):4059–4066 Chen L et al (2023) The effects of exercise on the quality of life of patients with breast cancer: a systematic review and meta-analysis based on the QLQ-C30 quality of life scale. Gland Surg 12(5):633–650 Taaffe DR et al (2017) Effects of Different Exercise Modalities on Fatigue in Prostate Cancer Patients Undergoing Androgen Deprivation Therapy: A Year-long Randomised Controlled Trial. Eur Urol 72(2):293–299 Galvão DA et al (2021) Psychological distress in men with prostate cancer undertaking androgen deprivation therapy: modifying effects of exercise from a year-long randomized controlled trial. Prostate Cancer Prostatic Dis 24(3):758–766 Courneya KS et al (2008) Predictors of supervised exercise adherence during breast cancer chemotherapy. Med Sci Sports Exerc 40(6):1180–1187 Ng AH et al (2021) Exercise Barriers and Adherence to Recommendations in Patients With Cancer. JCO Oncol Pract 17(7):e972–e981 Additional Declarations No competing interests reported. Supplementary Files EffectsofRTandHIITsupplementary2.10.docx Cite Share Download PDF Status: Published Journal Publication published 18 Nov, 2024 Read the published version in Breast Cancer Research and Treatment → Version 1 posted Editorial decision: Revision requested 30 Oct, 2024 Reviews received at journal 24 Oct, 2024 Reviewers agreed at journal 15 Oct, 2024 Reviewers invited by journal 06 Oct, 2024 Editor assigned by journal 03 Oct, 2024 Submission checks completed at journal 03 Oct, 2024 First submitted to journal 02 Oct, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-5191258\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":false,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":372356760,\"identity\":\"e83033c0-2d73-4fac-8ed4-d6da94fca47f\",\"order_by\":0,\"name\":\"Francesco Bettariga\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Edith Cowan University\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Francesco\",\"middleName\":\"\",\"lastName\":\"Bettariga\",\"suffix\":\"\"},{\"id\":372356761,\"identity\":\"cf7985f8-9c86-48ab-b13c-240a87328713\",\"order_by\":1,\"name\":\"Dennis R. Taaffe\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Edith Cowan University\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Dennis\",\"middleName\":\"R.\",\"lastName\":\"Taaffe\",\"suffix\":\"\"},{\"id\":372356762,\"identity\":\"d90da16f-78ca-46bf-ba15-393adcdf8f12\",\"order_by\":2,\"name\":\"Cristina Crespo Garcia\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Edith Cowan University\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Cristina\",\"middleName\":\"Crespo\",\"lastName\":\"Garcia\",\"suffix\":\"\"},{\"id\":372356763,\"identity\":\"8d00d9ed-6f81-4c7e-a689-48bfd94e6a4c\",\"order_by\":3,\"name\":\"Timothy D. Clay\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"St John of God Subiaco Hospital\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Timothy\",\"middleName\":\"D.\",\"lastName\":\"Clay\",\"suffix\":\"\"},{\"id\":372356764,\"identity\":\"cac9a0a5-4540-48bc-9fa5-99ee59742895\",\"order_by\":4,\"name\":\"Daniel A. 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Newton\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyklEQVRIiWNgGAWjYDADfgjFTKz6BAYGyQaStRgcIFaLeQPvwce8P2zyjI83P5NgqLBObGA/Y4BXi8wBvmRjnoS0YrMzx8wkGM6kJzbw5ODXIsHAYyadk3A4cduNHDYJxrbDiQ0MhLWY/wZp2Tz/DVDLP6AW/jeEbWEGadkgwQPU0gDUIkHIFmYeY+k/aWmJM86kGVskHEs3bpN4VoBfC3uP4ccZNjaJ/e2HH974UGMt28+fvAGvFtSISABiNvzqR8EoGAWjYBQQAwCI6j0jaSDOcwAAAABJRU5ErkJggg==\",\"orcid\":\"\",\"institution\":\"Edith Cowan University\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"Robert\",\"middleName\":\"U.\",\"lastName\":\"Newton\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2024-10-02 07:23:19\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-5191258/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-5191258/v1\",\"draftVersion\":[],\"editorialEvents\":[{\"content\":\"https://doi.org/10.1007/s10549-024-07559-5\",\"type\":\"published\",\"date\":\"2024-11-18T15:58:09+00:00\"}],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":68538556,\"identity\":\"4fa569de-7309-4ac7-96b6-85c67dbcb163\",\"added_by\":\"auto\",\"created_at\":\"2024-11-08 10:27:57\",\"extension\":\"png\",\"order_by\":1,\"title\":\"Figure 1\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":99211,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eConsolidated Standards of Reporting Trials (CONSORT) diagram.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"1.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-5191258/v1/883fad0da9cce60f1c10e553.png\"},{\"id\":69835595,\"identity\":\"7c19c10b-a199-454b-859b-3799a5f2192d\",\"added_by\":\"auto\",\"created_at\":\"2024-11-25 16:13:42\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":1020605,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-5191258/v1/2eca4d28-205d-489b-b747-5301f26d37cc.pdf\"},{\"id\":68538557,\"identity\":\"6f1702db-f1b4-428c-acd8-908022b01053\",\"added_by\":\"auto\",\"created_at\":\"2024-11-08 10:27:57\",\"extension\":\"docx\",\"order_by\":1,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":17342,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"EffectsofRTandHIITsupplementary2.10.docx\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-5191258/v1/81309e2d449e24a8daef7d5f.docx\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"The effects of resistance training vs high intensity interval training on body composition, muscle strength, cardiorespiratory fitness, and quality of life in survivors of breast cancer: a randomized trial\",\"fulltext\":[{\"header\":\"1. Introduction\",\"content\":\"\\u003cp\\u003eBreast cancer is a significant global health challenge, contributing to high morbidity and mortality [\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e]. In 2022, there were 2.3\\u0026nbsp;million new breast cancer cases and 660,000 breast cancer deaths worldwide, making breast cancer the most diagnosed and the leading cause of cancer-related death in women [\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eBreast cancer treatments, particularly chemotherapy, ovarian function suppression and endocrine therapy, are associated with a range of adverse effects, including not only an increase in body weight, but also loss of lean mass (LM) and increase in fat mass (FM) [\\u003cspan additionalcitationids=\\\"CR3 CR4 CR5\\\" citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e]. Such alterations are relevant as body composition components are associated with breast cancer-specific mortality [\\u003cspan additionalcitationids=\\\"CR8\\\" citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e]. This association may be due to the critical role that skeletal muscle and adipose tissue play as secretory organs with the release of hormones (e.g., insulin) and cytokines (e.g., interleukin 6) [\\u003cspan additionalcitationids=\\\"CR11\\\" citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e]. These hormones and cytokines have effects on metabolism, inflammation, the immune system, and tumorigenesis [\\u003cspan additionalcitationids=\\\"CR13\\\" citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e]. However, in the state of excessive adipose tissue and/or lowered skeletal muscle mass, their functions may be disrupted and out of balance leading to alterations in circulating factors [\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e]. In addition, breast cancer and the related treatments lead to reduced muscle strength and cardiorespiratory fitness (CRF) [\\u003cspan additionalcitationids=\\\"CR16\\\" citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR17\\\" class=\\\"CitationRef\\\"\\u003e17\\u003c/span\\u003e], which are predictors of all-cause mortality in patients with cancer [\\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e]. Furthermore, such alterations in body composition and physical fitness, along with cancer-related fatigue, anxiety, depression, and pain, commonly observed in breast cancer survivors lead to reduced quality of life (QoL) [\\u003cspan additionalcitationids=\\\"CR21\\\" citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eExercise is acknowledged as an essential therapeutic strategy in cancer management [\\u003cspan additionalcitationids=\\\"CR24 CR25\\\" citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR26\\\" class=\\\"CitationRef\\\"\\u003e26\\u003c/span\\u003e]. A robust body of evidence supports exercise to be safe and effective during or post-cancer treatment to improve various health outcomes. More importantly exercise is also associated with a 40% reduced risk of recurrence and longer survival [\\u003cspan additionalcitationids=\\\"CR24 CR25 CR26\\\" citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR27\\\" class=\\\"CitationRef\\\"\\u003e27\\u003c/span\\u003e]. Moreover, it is well known that long-term exercise programs reduce body weight and FM and improve LM in breast cancer survivors, especially when coupled with dietary intervention [\\u003cspan additionalcitationids=\\\"CR29\\\" citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR30\\\" class=\\\"CitationRef\\\"\\u003e30\\u003c/span\\u003e]. Such alterations in body composition induced by exercise are relevant not only for improvements in physical and psychological outcomes, but also for their effects on circulating factors that may affect disease progression [\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e, \\u003cspan additionalcitationids=\\\"CR32 CR33\\\" citationid=\\\"CR31\\\" class=\\\"CitationRef\\\"\\u003e31\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR34\\\" class=\\\"CitationRef\\\"\\u003e34\\u003c/span\\u003e]. Appropriately targeted exercise programs not only enhance muscle strength and CRF levels in breast cancer survivors, but also improve cancer-related fatigue, anxiety, depression, and pain, leading to enhanced QoL [\\u003cspan additionalcitationids=\\\"CR36 CR37\\\" citationid=\\\"CR35\\\" class=\\\"CitationRef\\\"\\u003e35\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR38\\\" class=\\\"CitationRef\\\"\\u003e38\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eWhen considering the type of exercise undertaken, two distinct modes have commonly been used: resistance training (RT) and aerobic training (AT), the latter of which can generally be performed as moderate intensity continuous training (MICT) or high intensity interval training (HIIT) [\\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e]. HIIT is a time efficient form of training and in clinical populations (e.g., CVD, diabetes, obesity) including those with cancer, HIIT has been shown to result in greater CRF benefits compared to MICT, and to reduce FM [\\u003cspan additionalcitationids=\\\"CR40 CR41\\\" citationid=\\\"CR39\\\" class=\\\"CitationRef\\\"\\u003e39\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR42\\\" class=\\\"CitationRef\\\"\\u003e42\\u003c/span\\u003e]. To date, and in line with current guidelines, the majority of exercise trials in breast cancer survivors have utilised combined RT and AT [\\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e]; however, no studies have been conducted comparing RT vs HIIT as sole exercise modes in breast cancer survivors. Characterizing specific changes induced by each exercise mode in breast cancer survivors would aid in more precise application of exercise medicine. Therefore, the aim of this study was to examine the effects of a 12-week supervised RT vs HIIT intervention on body composition, muscle strength, CRF, and QoL. Our hypothesis was that RT would be superior to HIIT for enhancing muscle strength and LM while HIIT would be superior for improving CRF and decreasing FM.\\u003c/p\\u003e\"},{\"header\":\"2. Methods\",\"content\":\"\\u003cp\\u003eThis was a two-arm randomized trial comparing a 12-week RT vs HIIT intervention on body composition, muscle strength, CRF, and QoL in breast cancer survivors. Ethical approval was obtained from the Edith Cowan University Human Research Ethics Committee (ID: 2023-04617-BETTARIGA) and the trial was registered on ANZCTR (ID: ACTRN12624000820505).\\u003c/p\\u003e \\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.1. Participants, recruitment, and allocation\\u003c/h2\\u003e \\u003cp\\u003eEligible participants were: 1) women originally diagnosed with stage I-III breast cancer; 2) with or without endocrine therapy; 3) completed primary treatment (e.g., chemotherapy, radiation therapy, surgery) at least 4 months prior; 4) body mass index (BMI) from 18.5 to 35 kg/m\\u003csup\\u003e2\\u003c/sup\\u003e; 5) medically cleared for exercise; and 6) willing and able to comply with all study requirements, including treatment, timing and/or nature of required assessments. Exclusion criteria were: 1) any known absolute contraindication to exercise; 2) currently completing vigorous exercise in the past 3 months (i.e., AT\\u0026thinsp;\\u0026ge;\\u0026thinsp;150 or 75 minutes at moderate or high intensity, respectively, or RT\\u0026thinsp;\\u0026ge;\\u0026thinsp;2 sessions per week); 3) life expectancy\\u0026thinsp;\\u0026lt;\\u0026thinsp;12 months; and 4) pregnant or lactating. Additionally, participants were required to maintain their habitual diet throughout the exercise training intervention.\\u003c/p\\u003e \\u003cp\\u003eRecruitment occurred between 1st October 2023 and 1st July 2024 at the Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia. All participants were informed as to the purpose of the study and written informed consent was obtained before commencement of the study. Participants were randomly assigned using a digital software program to RT or HIIT in a ratio of 1:1.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec4\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.2. Outcome measures\\u003c/h2\\u003e \\u003cdiv id=\\\"Sec5\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e2.2.1. Body composition\\u003c/h2\\u003e \\u003cp\\u003eWhole body LM and FM in kg, appendicular lean mass (ALM) in kg/m\\u003csup\\u003e2\\u003c/sup\\u003e, lean mass percentage (LM%) and body fat percentage (FM%), as well as visceral adipose tissue mass (VAT) in grams were assessed using dual-energy x-ray absorptiometry (DXA; Horizon A, Hologic, Washington, USA) [\\u003cspan citationid=\\\"CR43\\\" class=\\\"CitationRef\\\"\\u003e43\\u003c/span\\u003e]. ALM was calculated as the sum of upper limb and lower limb bone-free lean mass.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec6\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e2.2.2. Muscle strength and cardiorespiratory fitness\\u003c/h2\\u003e \\u003cp\\u003eChest press and leg press muscle strength were assessed using the 1-repetition maximum (1RM) test [\\u003cspan citationid=\\\"CR44\\\" class=\\\"CitationRef\\\"\\u003e44\\u003c/span\\u003e]. The 1RM is the maximum resistance that can be moved through a full range of motion, maintaining the correct body position and technique [\\u003cspan citationid=\\\"CR44\\\" class=\\\"CitationRef\\\"\\u003e44\\u003c/span\\u003e]. All participants were familiarized with the testing procedures and 1RM was determined when participants could perform only 1 repetition at a given resistance. For cardiorespiratory fitness, maximal oxygen uptake (VO2max) was assessed using the sub-maximal Ekblom-Bak test on a cycle ergometer pedalling at 60 RPM [\\u003cspan citationid=\\\"CR45\\\" class=\\\"CitationRef\\\"\\u003e45\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR46\\\" class=\\\"CitationRef\\\"\\u003e46\\u003c/span\\u003e]. All participants were familiarized with testing procedures and Borg\\u0026rsquo;s 6 to 20 rating of perceived exertion (RPE) scale [\\u003cspan citationid=\\\"CR47\\\" class=\\\"CitationRef\\\"\\u003e47\\u003c/span\\u003e]. The test included 2 x 4-minute sub-maximal bouts, starting with 0.5 kilopond and individually increased based on RPE. Heart rate was collected electronically and a computer program was used to predict VO2max [\\u003cspan citationid=\\\"CR46\\\" class=\\\"CitationRef\\\"\\u003e46\\u003c/span\\u003e]. Muscle strength and CRF tests were conducted on separate days and participants were required to avoid any strenuous activity at least 48 hours before the test with a 72-hour rest period between the final exercise session and post-intervention testing.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec7\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e2.2.3. Quality of life\\u003c/h2\\u003e \\u003cp\\u003eThe European Organization for Research and Treatment of Cancer questionnaires, EORTC QLQ-C30 and EORTC QLQ-BR45, were administered to all participants to evaluate global health, function, and symptom domains [\\u003cspan citationid=\\\"CR48\\\" class=\\\"CitationRef\\\"\\u003e48\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR49\\\" class=\\\"CitationRef\\\"\\u003e49\\u003c/span\\u003e]. The domains of function in the QLQ-C30 and BR45 include different items, such as physical, role, emotional, cognitive, social, and sexual functioning, whilst the domains of symptoms in the QLQ-C30 and BR45 encompass fatigue, nausea, pain, dyspnoea, insomnia, appetite loss, breast symptoms, and financial difficulties. The sum of each item led to the summary score for that domain. For global health and function, higher scores indicate higher QoL and functioning, whilst for symptoms lower scores indicate lower symptomatology.\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec8\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.3. Exercise intervention\\u003c/h2\\u003e \\u003cp\\u003eParticipants exercised 3 days per week for 12 weeks under supervision. Each exercise session lasted approximately 60 min, including warm-up and cool-down. Participants allocated to RT performed 8 to 12 repetitions for 3 to 5 sets of major muscle group exercises, including chest press, seated row, shoulder press, lat pulldown, leg press, leg extension, leg curl, and lunges (Supplementary Table\\u0026nbsp;1). Intensity was adjusted according to participants\\u0026rsquo; tolerance in order to achieve an RPE of 5 to 9 (using the 1 to 10 RPE scale [\\u003cspan citationid=\\\"CR50\\\" class=\\\"CitationRef\\\"\\u003e50\\u003c/span\\u003e]) or 60 to 80% 1RM [\\u003cspan citationid=\\\"CR51\\\" class=\\\"CitationRef\\\"\\u003e51\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR52\\\" class=\\\"CitationRef\\\"\\u003e52\\u003c/span\\u003e]. A 60- to 120-second rest period was provided between sets. For time efficiency and to minimize fatigue, exercises were alternated between the upper and lower body (e.g., chest press then leg press).\\u003c/p\\u003e \\u003cp\\u003eParticipants allocated to HIIT performed 5 to 7 bouts of 30 seconds at high intensity, with active recovery ranging from 30 to 60 seconds, for 4 to 6 sets on a stationary cycle, treadmill, rower, or cross-trainer (Supplementary Table\\u0026nbsp;2). Intensity was adjusted according to participants\\u0026rsquo; tolerance in order to achieve an RPE of 5 to 9 (using the 1 to 10 RPE scale [\\u003cspan citationid=\\\"CR53\\\" class=\\\"CitationRef\\\"\\u003e53\\u003c/span\\u003e]) or 60 to 90% of estimated HRmax (220 \\u0026ndash; age) for the high intensity bouts. During the active recovery repetitions participants were required to maintain a slow pace at an RPE of \\u0026asymp;\\u0026thinsp;3. A 180-second rest period was provided between sets. Different work to rest ratio schemes based on bout duration and active recovery were provided. Both RT and HIIT were periodised aiming to increase the exercise load over 12 weeks in a non-linear fashion [\\u003cspan citationid=\\\"CR54\\\" class=\\\"CitationRef\\\"\\u003e54\\u003c/span\\u003e].\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec9\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.4. Statistical analysis\\u003c/h2\\u003e \\u003cp\\u003eRegarding statistical power, we would consider a difference between groups in our outcomes of interest of 1 SD to be clearly important. To achieve 80% power at an alpha level of 0.05 (two-tailed), 16 participants per group are required for a total of 32 participants. Data were analysed using SPSS (version 25.0; SPSS, Inc., Armonk, NY). Normality of the distribution was assessed using the Shapiro-Wilk test and all data were normally distributed (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;\\u0026gt;\\u0026thinsp;0.05). For baseline comparisons, independent \\u003cem\\u003et\\u003c/em\\u003e-tests were used for continuous data and Chi-square for categorical variables. Paired sample \\u003cem\\u003et\\u003c/em\\u003e-test was used to examine the within-group changes. Group x time repeated measures ANOVA was used to calculate between-group intervention effects on body composition, muscle strength, CRF, and QoL domains. Tests were two-tailed, and a p-value\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05 was considered statistically significant.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"3. Results\",\"content\":\"\\u003cp\\u003eSixty breast cancer survivors were assessed for eligibility, with 32 recruited and randomized to RT or HIIT (Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e). Four participants withdrew from the study for family and health reasons not related to the exercise intervention. Baseline characteristics were similar between the two groups, apart from the number of women who received chemotherapy during cancer treatment which was higher in the HIIT group (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.012) (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e). Attendance rate was 85% for RT and 81% for HIIT. No major adverse events were reported or observed during the exercise interventions or testing. However, minor adverse events, including muscle soreness and temporary fatigue, were transient and resolved without intervention. BMI and body weight did not significantly change from pre- to post-intervention and no between-group differences were observed.\\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eBaseline participant characteristics.\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"5\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eRT (n\\u0026thinsp;=\\u0026thinsp;14)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eHIIT (n\\u0026thinsp;=\\u0026thinsp;14)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003ep-value\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eAge (years)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e61.8\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;8.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e56.9\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;8.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.194\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eBody weight (kg)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e77.7\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;11.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e78.1\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;21.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.958\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eHeight (cm)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e165.7\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;7.0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e168.4\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;7.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.542\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eBMI (kg/m\\u003c/b\\u003e\\u003csup\\u003e\\u003cb\\u003e2\\u003c/b\\u003e\\u003c/sup\\u003e\\u003cb\\u003e)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e28.4\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;4.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e27.5\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;5.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.633\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eTime since diagnosis (months)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e28.6\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;8.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e34.7\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;20.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.312\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\" morerows=\\\"2\\\" rowspan=\\\"3\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eCancer stage (%)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e1\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e50\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e29\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\" morerows=\\\"2\\\" rowspan=\\\"3\\\"\\u003e \\u003cp\\u003e0.228\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e2\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e35\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e42\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e3\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e15\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e29\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eUndertaking hormone therapy (%)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e70\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e78\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.663\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\" morerows=\\\"2\\\" rowspan=\\\"3\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003ePrevious treatments (%)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eChemotherapy\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e50\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e93\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.012\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eRadiation therapy\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e57\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e64\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.699\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eSurgery\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e100\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e100\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e1.000\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003ePostmenopausal status (%)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e70\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e64\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.686\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eHypertension (%)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e28\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e21\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.663\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\" morerows=\\\"2\\\" rowspan=\\\"3\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eEthnicity (%)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eNon-Hispanic white\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e70\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e70\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e1.000\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eAfrican-America\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e14\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e14\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e1.000\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eAsian/Pacific islander\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e14\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e14\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e1.000\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eMarried (%)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e70\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e78\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.663\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eCompleted university (%)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e57\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e28\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.127\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eFull-time employed (%)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e50\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e35\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.445\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eCurrent smoker (%)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e1.000\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eCurrent drinker (%)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e21\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e14\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.622\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eUndertaking other medications (e.g., metformin, vitamin D etc) (%)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e43\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e43\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e1.000\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003ctfoot\\u003e \\u003ctr\\u003e\\u003ctd colspan=\\\"5\\\"\\u003eLegend: RT\\u0026thinsp;=\\u0026thinsp;resistance training; HIIT\\u0026thinsp;=\\u0026thinsp;high intensity interval training.\\u003c/td\\u003e\\u003c/tr\\u003e \\u003c/tfoot\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cdiv id=\\\"Sec11\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e3.1. Body composition\\u003c/h2\\u003e \\u003cp\\u003eThere was no difference between groups at baseline for any body composition measure. Within and between-group changes for body composition are shown in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e. When examining the between-group changes, there was a significant effect for time for LM% (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.002), FM (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.041), and FM% (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.003), with no significant group x time interactions for any body composition measure.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab2\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 2\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eWithin and between-group changes in body composition for RT and HIIT groups.\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"14\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c6\\\" colnum=\\\"6\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c7\\\" colnum=\\\"7\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c8\\\" colnum=\\\"8\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c9\\\" colnum=\\\"9\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c10\\\" colnum=\\\"10\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c11\\\" colnum=\\\"11\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c12\\\" colnum=\\\"12\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c13\\\" colnum=\\\"13\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c14\\\" colnum=\\\"14\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\" morerows=\\\"2\\\" rowspan=\\\"3\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"5\\\" nameend=\\\"c6\\\" namest=\\\"c2\\\"\\u003e \\u003cp\\u003eRT (n\\u0026thinsp;=\\u0026thinsp;14)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"5\\\" nameend=\\\"c11\\\" namest=\\\"c7\\\"\\u003e \\u003cp\\u003eHIIT (n\\u0026thinsp;=\\u0026thinsp;14)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"3\\\" nameend=\\\"c14\\\" namest=\\\"c12\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003ePre\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003ePost\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"3\\\" nameend=\\\"c6\\\" namest=\\\"c4\\\"\\u003e \\u003cp\\u003eWithin-group changes\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003ePre\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003ePost\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"3\\\" nameend=\\\"c11\\\" namest=\\\"c9\\\"\\u003e \\u003cp\\u003eWithin-group changes\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"3\\\" nameend=\\\"c14\\\" namest=\\\"c12\\\"\\u003e \\u003cp\\u003eBetween-group changes\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003emean\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;SD\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003emean\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;SD\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eMD\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e95%CI\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003ep-value\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003emean\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;SD\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003emean\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;SD\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003eMD\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e95%CI\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003ep-value\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003eMD\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e95%CI\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003ep-value *\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eLean mass (kg)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e42.2\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;4.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e42.8\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;4.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.1 to 1.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.049\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e42.1\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;8.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e42.4\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;8.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e-0.5 to 1.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e0.362\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e0.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e-0.7 to 1.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0.662\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e% Lean mass\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e54.7\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;3.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e55.3\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;4.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.1 to 1.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.022\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e54.9\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;5.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e55.5\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;5.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e0.1 to 1.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e0.037\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e0.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e-0.1 to 0.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0.897\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eAppendicular lean/height (kg/m2)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e6.4\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e6.5\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e-0.1 to 0.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.090\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e6.0\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e6.1\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e-0.1 to 0.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e0.434\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e0.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e-0.1 to 0.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0.542\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eFat mass (kg)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e33.3\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;7.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e32.9\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;7.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-0.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e-1.1 to 0.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.239\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e33.9\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;12.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e33.3\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;11.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e-0.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e-1.5 to 0.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e0.100\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e0.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e-1.3 to 0.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0.588\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e% Fat mass\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e42.5\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;4.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e41.9\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;4.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-0.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e-1.2 to -0.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.031\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e42.4\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;6.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e41.8\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;5.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e-0.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e-1.1 to -0.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e0.039\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e0.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e-0.8 to 0.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0.937\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eVAT (g)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e563.4\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;277.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e557.4\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;262.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e-59.2 to 47.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.811\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e497.0\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;229.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e474.6\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;217.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e-22.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e-57.1 to 12.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e0.185\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e16.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e-76.9 to 43.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0.580\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003ctfoot\\u003e \\u003ctr\\u003e\\u003ctd colspan=\\\"14\\\"\\u003eLegend: RT\\u0026thinsp;=\\u0026thinsp;resistance training; HIIT\\u0026thinsp;=\\u0026thinsp;high intensity interval training; BMI\\u0026thinsp;=\\u0026thinsp;body mass index; kg\\u0026thinsp;=\\u0026thinsp;kilograms; g\\u0026thinsp;=\\u0026thinsp;grams; SD\\u0026thinsp;=\\u0026thinsp;standard deviation; MD\\u0026thinsp;=\\u0026thinsp;mean difference; CI\\u0026thinsp;=\\u0026thinsp;confidence interval; * = group x time interaction p-values.\\u003c/td\\u003e\\u003c/tr\\u003e \\u003c/tfoot\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003eFor RT, significant changes (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05) from pre- to post-intervention were observed for LM (mean difference [MD]\\u0026thinsp;=\\u0026thinsp;0.6 kg), LM% (MD\\u0026thinsp;=\\u0026thinsp;0.6%), and FM% (MD = -0.6%), with no significant change for ALM, FM, or VAT. For HIIT, significant changes (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05) from pre- to post-intervention were observed for LM% (MD\\u0026thinsp;=\\u0026thinsp;0.6%) and FM% (MD = -0.6%), with no significant change for LM, ALM, FM, or VAT.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec12\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e3.2. Muscle strength and cardiorespiratory fitness\\u003c/h2\\u003e \\u003cp\\u003eThere was no difference between groups at baseline for muscle strength or CRF. Within and between-group changes for physical fitness are shown in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab3\\\" class=\\\"InternalRef\\\"\\u003e3\\u003c/span\\u003e. When examining the between-group changes, there was a significant group x time interaction for chest press strength (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.001) with a greater increase in RT, and for VO2max (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001) with a greater increase for HIIT. In addition, there was a significant effect for time for leg press strength (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.001).\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab3\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 3\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eWithin and between-group changes in physical fitness and QoL for RT and HIIT groups.\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"14\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c6\\\" colnum=\\\"6\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c7\\\" colnum=\\\"7\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c8\\\" colnum=\\\"8\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c9\\\" colnum=\\\"9\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c10\\\" colnum=\\\"10\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c11\\\" colnum=\\\"11\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c12\\\" colnum=\\\"12\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c13\\\" colnum=\\\"13\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c14\\\" colnum=\\\"14\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"5\\\" nameend=\\\"c6\\\" namest=\\\"c2\\\"\\u003e \\u003cp\\u003eRT (n\\u0026thinsp;=\\u0026thinsp;14)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"5\\\" nameend=\\\"c11\\\" namest=\\\"c7\\\"\\u003e \\u003cp\\u003eHIIT (n\\u0026thinsp;=\\u0026thinsp;14)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"3\\\" nameend=\\\"c14\\\" namest=\\\"c12\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\" morerows=\\\"1\\\" rowspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003ePre\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003ePost\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"3\\\" nameend=\\\"c6\\\" namest=\\\"c4\\\"\\u003e \\u003cp\\u003eWithin-group changes\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003ePre\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003ePost\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"3\\\" nameend=\\\"c11\\\" namest=\\\"c9\\\"\\u003e \\u003cp\\u003eWithin-group changes\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"3\\\" nameend=\\\"c14\\\" namest=\\\"c12\\\"\\u003e \\u003cp\\u003eBetween-group changes\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003emean\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;SD\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003emean\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;SD\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eMD\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e95%CI\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003ep-value\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003emean\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;SD\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003emean\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;SD\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003eMD\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e95%CI\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003ep-value\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003eMD\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e95%CI\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003ep-value *\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eSTR - Chest press (kg)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e19.9\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;6.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e27.8\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;6.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e7.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e5.5 to 10.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e22.7\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;6.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e25.9\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;7.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e3.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e1.6 to 4.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e0.001\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e4.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e1.9 to 7.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0.001\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eSTR - Leg press (kg)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e66.1\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;28.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e90.2\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;28.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e24.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e14.9 to 33.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e82.2\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;18.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e98.3\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;18.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e16.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e13.4 to 18.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e8.0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e-1.1 to 17.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0.083\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eCRF (ml/min/kg)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e24.4\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;3.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e25.3\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;4.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.5 to 1.32\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.001\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e25.9\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;3.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e28.7\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;4.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e2.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e1.9 to 3.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e1.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e1.0 to 2.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eQLQ-C30 - Global health\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e9.6\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;2.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e11.0\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.1 to 2.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.033\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e10.3\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e11.6\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e1.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e0.2 to 2.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e0.018\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e0.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e-1.3 to 1.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0.777\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eQLQ-C30 - Function\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e22.6\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;4.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e23.9\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;3.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.9 to 3.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.231\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e19.5\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;2.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e22.5\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;3.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e3.0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e1.3 to 4.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e0.002\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e1.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e-0.9 to 4.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0.193\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eQLQ-C30 - Symptoms\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e22.0\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;4.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e19.1\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;3.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-2.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e-4.8 to 1.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.006\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e20.8\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;3.0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e19.9\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;3.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e-0.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e-2.5 to 0.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e0.290\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e2.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e-0.3 to 4.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0.090\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eQLQ-BR45 - Function\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e23.0\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;5.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e25.1\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;5.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e2.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.5 to 3.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.016\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e25.0\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;5.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e26.8\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;5.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e1.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e0.1 to 3.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e0.048\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e0.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e-1.99 to 2.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0.798\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eQLQ-BR45 - Symptoms\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e54.7\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;10.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e48.1\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;8.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-6.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e-10.5 to -2.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.002\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e55.4\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;11.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e51.3\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;9.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e-4.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e-7.4 to -0.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e0.019\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e2.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e-2.2 to 7.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0.281\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003ctfoot\\u003e \\u003ctr\\u003e\\u003ctd colspan=\\\"14\\\"\\u003eLegend: RT\\u0026thinsp;=\\u0026thinsp;resistance training; HIIT\\u0026thinsp;=\\u0026thinsp;high intensity interval training; STR\\u0026thinsp;=\\u0026thinsp;strength; CP\\u0026thinsp;=\\u0026thinsp;chest press; LP\\u0026thinsp;=\\u0026thinsp;leg press; CRF\\u0026thinsp;=\\u0026thinsp;cardiorespiratory function; kg\\u0026thinsp;=\\u0026thinsp;kilograms; SD\\u0026thinsp;=\\u0026thinsp;standard deviation; MD\\u0026thinsp;=\\u0026thinsp;mean difference; CI\\u0026thinsp;=\\u0026thinsp;confidence interval; * = group x time interaction p-values.\\u003c/td\\u003e\\u003c/tr\\u003e \\u003c/tfoot\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003eFor RT, significant improvements (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001) from pre- to post-intervention were observed for chest press (MD\\u0026thinsp;=\\u0026thinsp;7.9 kg) and leg press (MD\\u0026thinsp;=\\u0026thinsp;24.1 kg) strength, and VO2max (MD\\u0026thinsp;=\\u0026thinsp;0.9 ml/min/kg). For HIIT, significant improvements (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001) from pre- to post-intervention were observed for chest press (MD\\u0026thinsp;=\\u0026thinsp;3.2 kg) and leg press (MD\\u0026thinsp;=\\u0026thinsp;16.1 kg) strength, and VO2max (MD\\u0026thinsp;=\\u0026thinsp;2.8 ml/min/kg).\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec13\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e3.3. Quality of life\\u003c/h2\\u003e \\u003cp\\u003eThere was no difference between groups at baseline for any QoL measure. Within and between-group changes for QoL are shown in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab3\\\" class=\\\"InternalRef\\\"\\u003e3\\u003c/span\\u003e. When examining the between-group changes, there was a significant effect for time for global health (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.002), function using the QLQ-C30 and BR45 (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05), and symptoms using the QLQ-C30 and BR45 (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05), with no significant group x time interactions for any QoL domain.\\u003c/p\\u003e \\u003cp\\u003eFor RT, significant improvements (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05) from pre- to post-intervention were observed for global health using the QLQ-C30 (MD\\u0026thinsp;=\\u0026thinsp;1.4) and function using the QLQ-BR45 (MD\\u0026thinsp;=\\u0026thinsp;2.1), as well as reductions in symptoms using the QLQ-C30 (MD = -2.9) and BR45 (MD = -6.6). For HIIT, significant improvements (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05) from pre- to post-intervention were observed for global health (MD\\u0026thinsp;=\\u0026thinsp;1.2) and function using QLQ-C30 (MD\\u0026thinsp;=\\u0026thinsp;3.0) and BR45 (MD\\u0026thinsp;=\\u0026thinsp;1.8), as well as reductions in symptoms using the QLQ-BR45 (MD = -4.1).\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"4. Discussion\",\"content\":\"\\u003cp\\u003eThis study examined the effects of a 12-week supervised RT vs HIIT intervention on body composition, muscle strength, CRF, and QoL in breast cancer survivors. There were three important findings. First, both RT and HIIT improved body composition to a similar extent pre- to post-intervention, without any significant difference between groups. Second, gains in upper and lower body muscle strength significantly favoured the RT group, with gains in CRF favouring the HIIT group. Third, although QoL questionnaires improved to a similar extent regardless of the intervention undertaken by the participants, there were no significant changes in function for participants in the RT group and in symptoms for those in the HIIT group.\\u003c/p\\u003e \\u003cp\\u003eBreast cancer survivors allocated to RT improved LM, LM%, and FM%, while those allocated to HIIT improved LM% and FM% over the 12-week intervention, although there was no significant difference between the two exercise modes. This corroborates findings from our recent meta-analysis in breast cancer survivors that RT is effective for enhancing LM and HIIT for reducing FM [\\u003cspan citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e]. Moreover, the magnitude of the changes observed in LM and FM are in line with the current literature in breast cancer survivors, where increases in LM by 0.7 and 0.4 kg and reductions in FM by 0.4 and 1.2 kg accompany isolated RT and AT, respectively [\\u003cspan additionalcitationids=\\\"CR29\\\" citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR30\\\" class=\\\"CitationRef\\\"\\u003e30\\u003c/span\\u003e]. Taken together, these changes in body composition, though modest, are of clinical relevance for breast cancer survivors [\\u003cspan citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e]. Indeed, adverse effects in body composition found after primary treatment are associated with higher disease recurrence and mortality rates [\\u003cspan additionalcitationids=\\\"CR8\\\" citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e]. However, both RT and HIIT programs were similar in inducing changes in body composition. The absence of between group differences may be attributed to the lack of dietary intervention, which is well known to play a major role in body composition changes in breast cancer survivors [\\u003cspan citationid=\\\"CR55\\\" class=\\\"CitationRef\\\"\\u003e55\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR56\\\" class=\\\"CitationRef\\\"\\u003e56\\u003c/span\\u003e]. In addition, although volume, intensity, and frequency adopted in RT were in line with current guidelines, exercise training programs with longer duration (e.g., 26 weeks) would likely result in greater alterations in body composition [\\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR57\\\" class=\\\"CitationRef\\\"\\u003e57\\u003c/span\\u003e] and potentially greater separation of mode-specific adaptations. In contrast, it is yet to be determined the optimal dose to induce changes in body composition when using a HIIT program [\\u003cspan citationid=\\\"CR58\\\" class=\\\"CitationRef\\\"\\u003e58\\u003c/span\\u003e]. Despite this, our findings are noteworthy owing to the isolated effects of RT and HIIT observed in our study.\\u003c/p\\u003e \\u003cp\\u003eBoth groups significantly improved upper and lower body muscle strength, with the RT group demonstrating significantly greater strength gains than the HIIT group. Although a significant enhancement of muscle strength was expected after 12 weeks of RT, improvements were also found with HIIT especially for lower body strength as represented by the leg press test. It is well-documented that RT increases muscle strength in patients with breast cancer [\\u003cspan citationid=\\\"CR59\\\" class=\\\"CitationRef\\\"\\u003e59\\u003c/span\\u003e], but less is known regarding the effects of HIIT on muscle strength [\\u003cspan citationid=\\\"CR58\\\" class=\\\"CitationRef\\\"\\u003e58\\u003c/span\\u003e]. Although speculative, it appears that the high intensity efforts during HIIT elicit improvement in muscle strength due to the physiological mechanisms induced by interval training, that is, increased firing frequency, enhanced motor unit recruitment and synchronization [\\u003cspan citationid=\\\"CR60\\\" class=\\\"CitationRef\\\"\\u003e60\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR61\\\" class=\\\"CitationRef\\\"\\u003e61\\u003c/span\\u003e]. Despite this, greater muscle strength increases were found after RT, further supporting the superior effects of RT on muscle strength [\\u003cspan citationid=\\\"CR62\\\" class=\\\"CitationRef\\\"\\u003e62\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR63\\\" class=\\\"CitationRef\\\"\\u003e63\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eRegarding CRF, both RT and HIIT programs significantly improved VO2max, with the improvement substantially more in the HIIT group. It is well known that HIIT drives substantial improvements in VO2max, leading to augmented CRF in breast cancer survivors [\\u003cspan citationid=\\\"CR58\\\" class=\\\"CitationRef\\\"\\u003e58\\u003c/span\\u003e]; however, it is yet to be determined to what extent RT can alter VO2max [\\u003cspan citationid=\\\"CR64\\\" class=\\\"CitationRef\\\"\\u003e64\\u003c/span\\u003e]. The relatively modest effect observed in VO2max could be attributed to local muscle adaptations, particularly in the case of RT, where improvements in oxygen extraction at the muscle level (peripheral adaptations) may have played a more significant role than central cardiovascular changes [\\u003cspan citationid=\\\"CR65\\\" class=\\\"CitationRef\\\"\\u003e65\\u003c/span\\u003e]. While RT can enhance muscular strength and endurance, its impact on central factors such as cardiac output may be limited compared to HIIT, which targets both peripheral and central adaptations [\\u003cspan citationid=\\\"CR65\\\" class=\\\"CitationRef\\\"\\u003e65\\u003c/span\\u003e]. Indeed, our findings support that HIIT induces substantial changes in CRF among breast cancer survivors. However, further research is needed to fully elucidate the extent of these changes, especially when comparing the effects of HIIT with MICT [\\u003cspan citationid=\\\"CR58\\\" class=\\\"CitationRef\\\"\\u003e58\\u003c/span\\u003e]. While initial results are promising, larger and more comprehensive studies are required to establish a clearer understanding of how MICT and HIIT influence CRF outcomes [\\u003cspan citationid=\\\"CR58\\\" class=\\\"CitationRef\\\"\\u003e58\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eOverall, breast cancer survivors completing the exercise training interventions significantly improved QoL, with no significant differences between groups, indicating that both exercise modes were similarly effective. Survivors not only improved global health and QoL aspects related to physical functioning (e.g., role, emotional, and sexual functioning), but also had reduced symptoms (e.g., fatigue, dyspnoea, and insomnia). This is of utmost importance when considering that exercise participation is associated with reduced symptoms and enhanced adherence to prescribed endocrine therapy [\\u003cspan citationid=\\\"CR66\\\" class=\\\"CitationRef\\\"\\u003e66\\u003c/span\\u003e]. Our results are in line with current evidence indicating exercise to be of benefit in enhancing QoL in breast cancer survivors, even though the specific effects of each exercise mode remain to be fully elucidated [\\u003cspan citationid=\\\"CR35\\\" class=\\\"CitationRef\\\"\\u003e35\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR67\\\" class=\\\"CitationRef\\\"\\u003e67\\u003c/span\\u003e]. In a similar fashion, we have shown in patients with prostate cancer that fatigue and psychological distress are enhanced with various exercise modes [\\u003cspan citationid=\\\"CR68\\\" class=\\\"CitationRef\\\"\\u003e68\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR69\\\" class=\\\"CitationRef\\\"\\u003e69\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eBoth RT and HIIT programs were safe and feasible with attendance rate classified as high [\\u003cspan citationid=\\\"CR70\\\" class=\\\"CitationRef\\\"\\u003e70\\u003c/span\\u003e]. To date, lack of enjoyment, fatigue, and boredom have been reported as reasons for low exercise adherence [\\u003cspan citationid=\\\"CR71\\\" class=\\\"CitationRef\\\"\\u003e71\\u003c/span\\u003e]. The programs employed a non-linear periodization (training variation) structure, which was chosen to maximise exercise adaptations while reducing staleness and fatigue [\\u003cspan citationid=\\\"CR54\\\" class=\\\"CitationRef\\\"\\u003e54\\u003c/span\\u003e], potentially addressing adherence concerns. The programs were also fully supervised, which is essential with sedentary participants or novice exercisers, ensuring safety and an effective exercise exposure.\\u003c/p\\u003e \\u003cp\\u003eTo the best of our knowledge, this is the first study comparing a RT and HIIT program in breast cancer survivors. The strengths of our study include the supervision, well-defined exercise specifics in terms of volume, intensity, and frequency as well as the \\u0026gt;\\u0026thinsp;80% adherence to the exercise intervention. In addition, a wide range of outcomes for body composition, muscle strength, CRF, and QoL, were undertaken providing a comprehensive overview of the impacts of different exercise modes on these outcomes. However, there are some limitations which are worthy of comment. The exercise prescriptions were in line with current guidelines; however, a longer duration (e.g., 26 weeks) would likely be preferrable to investigate changes in the outcomes of interest. In addition, although participants were asked to maintain their habitual lifestyle, dietary records were not undertaken. However, it should be noted that given that there were no substantial changes in body weight, it is unlikely that marked changes in dietary intake patterns occurred in either exercise group during the trial.\\u003c/p\\u003e\"},{\"header\":\"5. Conclusion\",\"content\":\"\\u003cp\\u003eIn summary, our findings are that both exercise interventions improved body composition in a similar fashion, with somewhat greater effects observed on LM in RT and a trend towards greater improvement on FM in HIIT. In addition, both RT and HIIT significantly enhanced physical fitness over the 12 weeks, with greater effects on upper body muscle strength with RT and CRF with HIIT. Lastly, QoL domains similarly improved regardless of the intervention. Tailored exercise programs can address health-related outcomes with specific adaptation, highlighting the need of creating exercise training plans that address the health and fitness concerns most relevant to each patient.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eConflict of interest\\u0026nbsp;\\u003c/strong\\u003eFrancesco Bettariga, Dennis R. Taaffe, Cristina Crespo Garcia, Timothy D. Clay,\\u0026nbsp;Daniel A.\\u0026nbsp;Galv\\u0026atilde;o,\\u0026nbsp;and Robert U. Newton\\u0026nbsp;declare that they have no conflicts of interest relevant to the content of this study.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eFunding\\u0026nbsp;\\u003c/strong\\u003eNo funding was received for this project.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthor contributions\\u003c/strong\\u003e FB drafted the manuscript. FB, CCG, and TC collected data. FB, DT, DG, and RN planned study design. FB, DT, CCG, TC, DG, and RN edited and revised the manuscript. All authors approved the final version before submission.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eData availability statement\\u003c/strong\\u003e The data that support the findings of this study are available from the corresponding author upon reasonable request. Personal data are securely stored in a restricted-access online system at our institute, ensuring compliance with privacy and data protection regulations.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eBray F et al (2024) Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 74(3):229\\u0026ndash;263\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAnbari AB, Deroche CB, Armer JM (2019) Body mass index trends and quality of life from breast cancer diagnosis through seven years' survivorship. World J Clin Oncol 10(12):382\\u0026ndash;390\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eDemark-Wahnefried W, Campbell KL, Hayes SC (2012) Weight management and its role in breast cancer rehabilitation. Cancer 118(8 Suppl):2277\\u0026ndash;2287\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eIrwin ML et al (2005) Changes in body fat and weight after a breast cancer diagnosis: influence of demographic, prognostic, and lifestyle factors. J Clin Oncol 23(4):774\\u0026ndash;782\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eSheean PM, Hoskins K, Stolley M (2012) Body composition changes in females treated for breast cancer: a review of the evidence. Breast Cancer Res Treat 135(3):663\\u0026ndash;680\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eFreedman RJ et al (2004) Weight and body composition changes during and after adjuvant chemotherapy in women with breast cancer. J Clin Endocrinol Metab 89(5):2248\\u0026ndash;2253\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAleixo GFP et al (2019) Muscle composition and outcomes in patients with breast cancer: meta-analysis and systematic review. Breast Cancer Res Treat 177(3):569\\u0026ndash;579\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eDeluche E et al (2018) Impact of body composition on outcome in patients with early breast cancer. Support Care Cancer 26(3):861\\u0026ndash;868\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCaan BJ et al (2018) Association of Muscle and Adiposity Measured by Computed Tomography With Survival in Patients With Nonmetastatic Breast Cancer. JAMA Oncol 4(6):798\\u0026ndash;804\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKershaw EE, Flier JS (2004) Adipose tissue as an endocrine organ. J Clin Endocrinol Metab 89(6):2548\\u0026ndash;2556\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePedersen BK (2013) Muscle as a secretory organ. Compr Physiol 3(3):1337\\u0026ndash;1362\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePedersen BK, Febbraio MA (2012) Muscles, exercise and obesity: skeletal muscle as a secretory organ. Nat Reviews Endocrinol 8(8):457\\u0026ndash;465\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBettariga F et al (2023) Suppressive effects of exercise-conditioned serum on cancer cells: A narrative review of the influence of exercise mode, volume, and intensity. 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J Sport Health Sci\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eJoaquim A et al (2022) Impact of physical exercise programs in breast cancer survivors on health-related quality of life, physical fitness, and body composition: Evidence from systematic reviews and meta-analyses. Front Oncol 12:955505\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKlassen O et al (2017) Muscle strength in breast cancer patients receiving different treatment regimes. J Cachexia Sarcopenia Muscle 8(2):305\\u0026ndash;316\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eFicarra S et al (2022) Impact of exercise interventions on physical fitness in breast cancer patients and survivors: a systematic review. 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Eur J Cancer 31a:13\\u0026ndash;14\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBjelic-Radisic V et al (2020) An international update of the EORTC questionnaire for assessing quality of life in breast cancer patients: EORTC QLQ-BR45. Ann Oncol 31(2):283\\u0026ndash;288\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eLea JWD et al (2022) Convergent Validity of Ratings of Perceived Exertion During Resistance Exercise in Healthy Participants: A Systematic Review and Meta-Analysis. Sports Med - Open 8(1):2\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eHerman L et al (2006) Validity and reliability of the session RPE method for monitoring exercise training intensity. South Afr Sports Med Association, 18\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eHelms ER et al (2018) RPE vs. Percentage 1RM Loading in Periodized Programs Matched for Sets and Repetitions. 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Br J Cancer 105(1):S52\\u0026ndash;S73\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eJia T et al (2022) Association of Healthy Diet and Physical Activity With Breast Cancer: Lifestyle Interventions and Oncology Education. Front Public Health 10:797794\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBellicha A et al (2021) Effect of exercise training on weight loss, body composition changes, and weight maintenance in adults with overweight or obesity: An overview of 12 systematic reviews and 149 studies. Obes Rev 22(S4):e13256\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eChen X et al (2023) High-intensity interval training in breast cancer patients: A systematic review and meta-analysis. Cancer Med 12(17):17692\\u0026ndash;17705\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eGerland L, Baumann FT, Niels T (2021) Resistance Exercise for Breast Cancer Patients? Evidence from the Last Decade. 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Prostate Cancer Prostatic Dis 24(3):758\\u0026ndash;766\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCourneya KS et al (2008) Predictors of supervised exercise adherence during breast cancer chemotherapy. Med Sci Sports Exerc 40(6):1180\\u0026ndash;1187\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eNg AH et al (2021) Exercise Barriers and Adherence to Recommendations in Patients With Cancer. JCO Oncol Pract 17(7):e972\\u0026ndash;e981\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":false,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":true,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"breast-cancer-research-and-treatment\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"brea\",\"sideBox\":\"Learn more about [Breast Cancer Research and Treatment](https://www.springer.com/journal/10549)\",\"snPcode\":\"10549\",\"submissionUrl\":\"https://submission.nature.com/new-submission/10549/3\",\"title\":\"Breast Cancer Research and Treatment\",\"twitterHandle\":\"\",\"acdcEnabled\":true,\"dfaEnabled\":true,\"editorialSystem\":\"stoa\",\"reportingPortfolio\":\"Springer Hybrid\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":false},\"keywords\":\"breast cancer, resistance training, high intensity interval training, body composition, physical fitness\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-5191258/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-5191258/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003e\\u003cstrong\\u003ePurpose.\\u003c/strong\\u003e Breast cancer treatments often lead to unfavourable changes in body composition, physical fitness, and quality of life (QoL). We compared the effects of resistance training (RT) and high-intensity interval training (HIIT) on these outcomes in survivors of breast cancer.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eMethods.\\u003c/strong\\u003e Twenty-eight survivors of breast cancer, post-treatment (Stage I-III), aged 55.5 ± 8.8 years and body mass index 27.9 ± 5 kg/m\\u003csup\\u003e2\\u003c/sup\\u003e were randomly allocated to a 12-week supervised RT or HIIT intervention, 3 days per week. Body composition, upper and lower body muscle strength, cardiorespiratory fitness (CRF), and QoL domains were assessed at baseline and 12 weeks.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eResults.\\u003c/strong\\u003e There were no significant differences at baseline between groups. Exercise attendance ranged from 81 to 85%. After 12 weeks, lean mass increased in the RT (mean difference [MD] = 0.6 kg, \\u003cem\\u003ep\\u003c/em\\u003e = 0.049), while % fat mass decreased in the HIIT (MD = -0.6%, \\u003cem\\u003ep\\u003c/em\\u003e = 0.039), with no significant differences between groups. Between-groups there were significant differences (\\u003cem\\u003ep\\u003c/em\\u003e \\u0026lt; 0.001) with improvement in chest press strength for RT (MD = 4.7 kg) and CRF for HIIT (MD = 1.9 ml/min/kg). There were significant within-group improvements (\\u003cem\\u003ep\\u003c/em\\u003e \\u0026lt; 0.001) in muscle strength and CRF for both RT and HIIT. QoL (global health, function, and symptoms) significantly improved (\\u003cem\\u003ep\\u003c/em\\u003e \\u0026lt; 0.05) in both groups, without any difference between groups. No major adverse events were noted.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConclusion.\\u003c/strong\\u003e Both exercise groups improved body composition, physical fitness, and QoL domains over 12 weeks of RT or HIIT, although mode-specific benefits were apparent with more substantial improvements in lean mass and muscle strength with RT and reductions in % fat mass and improved CRF with HIIT. Tailored exercise programs should address the specific health needs of each patient.\\u003c/p\\u003e\",\"manuscriptTitle\":\"The effects of resistance training vs high intensity interval training on body composition, muscle strength, cardiorespiratory fitness, and quality of life in survivors of breast cancer: a randomized trial\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2024-11-08 10:27:53\",\"doi\":\"10.21203/rs.3.rs-5191258/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0},{\"type\":\"decision\",\"content\":\"Revision requested\",\"date\":\"2024-10-30T18:02:33+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorInvitedReview\",\"content\":\"\",\"date\":\"2024-10-24T19:48:05+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"235728745799981196211100724345848819008\",\"date\":\"2024-10-15T15:15:58+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewersInvited\",\"content\":\"\",\"date\":\"2024-10-06T20:11:22+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorAssigned\",\"content\":\"\",\"date\":\"2024-10-03T15:32:52+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"checksComplete\",\"content\":\"\",\"date\":\"2024-10-03T15:32:45+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"submitted\",\"content\":\"Breast Cancer Research and Treatment\",\"date\":\"2024-10-02T07:18:30+00:00\",\"index\":\"\",\"fulltext\":\"\"}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"breast-cancer-research-and-treatment\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"brea\",\"sideBox\":\"Learn more about [Breast Cancer Research and Treatment](https://www.springer.com/journal/10549)\",\"snPcode\":\"10549\",\"submissionUrl\":\"https://submission.nature.com/new-submission/10549/3\",\"title\":\"Breast Cancer Research and Treatment\",\"twitterHandle\":\"\",\"acdcEnabled\":true,\"dfaEnabled\":true,\"editorialSystem\":\"stoa\",\"reportingPortfolio\":\"Springer Hybrid\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":false}}],\"origin\":\"\",\"ownerIdentity\":\"0d923978-85dd-4e7f-ada6-38e826676a13\",\"owner\":[],\"postedDate\":\"November 8th, 2024\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"published-in-journal\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2024-11-25T16:08:37+00:00\",\"versionOfRecord\":{\"articleIdentity\":\"rs-5191258\",\"link\":\"https://doi.org/10.1007/s10549-024-07559-5\",\"journal\":{\"identity\":\"breast-cancer-research-and-treatment\",\"isVorOnly\":false,\"title\":\"Breast Cancer Research and Treatment\"},\"publishedOn\":\"2024-11-18 15:58:09\",\"publishedOnDateReadable\":\"November 18th, 2024\"},\"versionCreatedAt\":\"2024-11-08 10:27:53\",\"video\":\"\",\"vorDoi\":\"10.1007/s10549-024-07559-5\",\"vorDoiUrl\":\"https://doi.org/10.1007/s10549-024-07559-5\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-5191258\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-5191258\",\"identity\":\"rs-5191258\",\"version\":[\"v1\"]},\"buildId\":\"qtupq5eGEP_6zYnWcrvyt\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}