ENDURANCE training plays a pivotal role in improving cardiorespiratory fitness in cancer survivors. A recent study examined whether two different intensity-based exercise approaches, pyramidal and threshold training, offered differing benefits to individuals recovering from breast or prostate cancer. The key finding was that both training methods significantly improved endurance capacity, yet threshold training achieved these results in less time.
55 cancer survivors were split into two groups, a threshold group (n=28) and a polarised group (n=27) and completed a 12-week, twice-weekly cycling intervention. Training sessions were designed to be isocaloric, meaning energy expenditure was equivalent between groups. Despite plans for a polarised intensity distribution, the polarised group performed a pyramidal distribution in practice. Training load was carefully measured using cardiopulmonary exercise testing and blood lactate thresholds. Participants were assessed for changes in peak oxygen uptake (VO2peak), peak power output (PPO), ventilatory and lactate thresholds, as well as markers of maximal exhaustion.
Both training regimens led to significant improvements in VO2peak (0.09 L/min for pyramidal; 0.12 L/min for threshold), PPO (27W vs. 17W), and thresholds (e.g., VT1 power output: 11W vs. 13W). No statistically significant differences in outcomes were observed between groups. However, threshold training required significantly less weekly training time (59±1 minutes) compared to 76±11 minutes in the pyramidal group (p<0.001). Training energy expenditure was similar across groups, reinforcing the role of energy output as a key driver of physiological adaptation.
In clinical practice, these findings suggest that both pyramidal and threshold training are safe, effective, and feasible options for improving fitness in cancer survivors post-treatment. Importantly, threshold training may be preferable for individuals with limited time availability, while pyramidal training could be more appealing to those who enjoy variety. A key limitation of this study is that the intended polarised intensity distribution was not achieved, precluding firm conclusions about its potential superiority. Further studies are needed to determine whether a true polarised regimen is both feasible and beneficial in this population. Nonetheless, the matched-energy design provides a valuable framework for comparing endurance training modalities in clinical oncology settings.
Reference
Bauer N et al. Effects of Different Training Intensity Distributions on Endurance Capacity in Breast and Prostate Cancer Survivors: A Randomized Controlled Trial. Eur J Sport Sci. 2025;DOI: 10.1002/ejsc.12287.
