BMC sports science, medicine & rehabilitation · 2026
High-intensity interval training in cancer patients: a bayesian meta-analysis of effects on VO2max, dose-response, and adherence.
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Zhang Jianbo, Tao Jingjing, Teo Frank Li Wen, Teo May Xin Yu
Аннотация
BACKGROUND: Cancer treatment impairs cardiorespiratory fitness (CRF), an independent prognostic indicator in cancer populations. High-intensity interval training (HIIT) improves maximal oxygen uptake (VO2max), but existing meta-analyses have relied on frequentist approaches without probabilistic expression of clinical relevance and have analyzed dose-response and adherence in isolation.
METHODS: Four databases were searched through 1 April 2026 for randomized controlled trials (RCTs) of HIIT versus non-exercise controls reporting VO2max. Mean differences (MDs) were pooled using a Bayesian three-level random-effects model, with the posterior median, 95% credible interval (CrI), probability of direction (pd), Bayes factor (BF10), and the posterior probability of exceeding a prespecified threshold of 1.0 mL·kg⁻1·min⁻1 reported. Functional-form comparison was applied to 14 dose moderators, and certainty of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
RESULTS: Sixteen RCTs contributing 35 effect sizes were included. HIIT increased VO2max by 2.61 mL·kg⁻1·min⁻1 versus non-exercise controls (95% CrI: 1.68 to 3.51), with pd = 1.00 and a 99.96% posterior probability of exceeding the threshold. The primary effect remained stable across all subgroup and sensitivity analyses. Dose-response curves showed minimal variation, and only the number of intervals reached pd = 0.95 among the 14 moderators. Mean adherence was 85.7%, with no prescription parameter showing a statistically significant association. Certainty of evidence was rated moderate.
CONCLUSIONS: HIIT reliably improves VO2max in cancer patients, with near-certain posterior probability of exceeding clinical relevance. Dose-response and adherence analyses were exploratory and underpowered and do not support dose equivalence. Interval number was the only directional signal and may warrant further investigation.
METHODS: Four databases were searched through 1 April 2026 for randomized controlled trials (RCTs) of HIIT versus non-exercise controls reporting VO2max. Mean differences (MDs) were pooled using a Bayesian three-level random-effects model, with the posterior median, 95% credible interval (CrI), probability of direction (pd), Bayes factor (BF10), and the posterior probability of exceeding a prespecified threshold of 1.0 mL·kg⁻1·min⁻1 reported. Functional-form comparison was applied to 14 dose moderators, and certainty of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
RESULTS: Sixteen RCTs contributing 35 effect sizes were included. HIIT increased VO2max by 2.61 mL·kg⁻1·min⁻1 versus non-exercise controls (95% CrI: 1.68 to 3.51), with pd = 1.00 and a 99.96% posterior probability of exceeding the threshold. The primary effect remained stable across all subgroup and sensitivity analyses. Dose-response curves showed minimal variation, and only the number of intervals reached pd = 0.95 among the 14 moderators. Mean adherence was 85.7%, with no prescription parameter showing a statistically significant association. Certainty of evidence was rated moderate.
CONCLUSIONS: HIIT reliably improves VO2max in cancer patients, with near-certain posterior probability of exceeding clinical relevance. Dose-response and adherence analyses were exploratory and underpowered and do not support dose equivalence. Interval number was the only directional signal and may warrant further investigation.