236. High-Intensity Aerobic Interval Training on Cardiovascular Disease

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236. High-Intensity Aerobic Interval Training on Cardiovascular Disease

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Abstract…………………………………………………………………………………………………………………………ii
Preface …………………………………………………………………………………………………………………………..v
Acknowledgements……………………………………………………………………………………………………….vii
Table of Contents ………………………………………………………………………………………………………..viii
List of Tables………………………………………………………………………………………………………………..xii
List of Figures……………………………………………………………………………………………………………..xiii
Key Dissertation Abbreviations……………………………………………………………………………………xiv
Chapter I – Introduction ………………………………………………………………………………………………..1
1.1 Testicular Cancer ………………………………………………………………………………………………….2
1.2 Treatment-Related Risks in Testicular Cancer Survivors……………………………………….3
1.2.1 Treatment-Related Risks: Cardiovascular Disease ……………………………………………4
1.2.2 Treatment-Related Risks: Psychosocial and HRQoL Impairments…………………….6
1.2.3 Summary: Testicular Cancer and Related Risks……………………………………………….8
1.3 Exercise Benefits in Healthy and Other Clinical Populations…………………………………..9
1.4 Exercise Benefits and Testicular Cancer Survivorship ……………………………………………9
1.4.1 Exercise Benefits: Cardiovascular…………………………………………………………………….9
1.4.2 Exercise Benefits: Psychosocial & HRQoL………………………………………………………11
1.4.3 Summary: Testicular Cancer and Aerobic Exercise ………………………………………..13
1.5 Overview of the Dissertation ………………………………………………………………………………..14
1.6 References…………………………………………………………………………………………………………..16
Chapter II – Primary Manuscript…………………………………………………………………………………30
2.1 Abstract………………………………………………………………………………………………………………33
2.2 Introduction ………………………………………………………………………………………………………..35

2.3 Methods………………………………………………………………………………………………………………36
2.4 Results ………………………………………………………………………………………………………………..40
2.5 Discussion……………………………………………………………………………………………………………42
2.6 References…………………………………………………………………………………………………………..45
Chapter III – Online Supplement for the Primary Manuscript………………………………………57
3.1 Participants…………………………………………………………………………………………………………58
3.2 Randomization and Blinding………………………………………………………………………………..58
3.3 Exercise Training and Usual Care Conditions………………………………………………………59
3.4 Assessment of Primary and Secondary Endpoints…………………………………………………60
3.4.1 Exercise Assessments ……………………………………………………………………………………..60
3.4.2 Resting Hemodynamic, Vascular, and Nervous System Assessments………………..61
3.4.3 Carotid Plaque……………………………………………………………………………………………….63
3.4.4 Carotid Intima-Media Thickness…………………………………………………………………….63
3.4.5 Carotid Distensibility ……………………………………………………………………………………..64
3.4.6 Flow-Mediated Dilation and Microvascular Function ……………………………………..64
3.4.7 Respiratory Sinus Arrhythmia ……………………………………………………………………….66
3.4.8 Pulse Wave Velocity……………………………………………………………………………………….67
3.4.9 Blood-based Biomarker Assessments………………………………………………………………68
3.4.10 Cardiovascular Disease Risk Assessments……………………………………………………..68
3.5 Statistical Analyses and Sample Size Calculation ………………………………………………….69
3.6 References…………………………………………………………………………………………………………..70
Chapter IV – Secondary Manuscript …………………………………………………………………………….77
4.1 Abstract………………………………………………………………………………………………………………79
4.2 Introduction ………………………………………………………………………………………………………..81

4.3 Methods………………………………………………………………………………………………………………83
4.4 Results ………………………………………………………………………………………………………………..87
4.5 Discussion……………………………………………………………………………………………………………89
4.6 References…………………………………………………………………………………………………………..94
4.7 Online Supplement…………………………………………………………………………………………….109
Chapter V – Discussion ……………………………………………………………………………………………….110
5.1 Overview …………………………………………………………………………………………………………..111
5.2 Summary of Findings…………………………………………………………………………………………111
5.3 Future Research Directions………………………………………………………………………………..115
5.4 Practical Implications………………………………………………………………………………………..122
5.5 Strengths and Limitations………………………………………………………………………………….125
5.6 Conclusions……………………………………………………………………………………………………….129
5.7 References…………………………………………………………………………………………………………131
Bibliography ………………………………………………………………………………………………………………139
Appendix A: TC Diagnostic and Prognostic Information……………………………………………..193
Appendix B: Methods of Cardiovascular Health Assessment ……………………………………….196
Appendix C: Methods of Psychosocial and HRQoL Health Assessment………………………..222
Appendix D: CVD Risk Screening & Treatment-Related CVD Risks in TCS ……………….228
Appendix E: The Role of Aerobic Exercise Training in TC Survivorship ……………………..252
Appendix F: Exercise Prescription Considerations for TCS …………………………………………274
Appendix G: HIITTS Trial Cover Letter …………………………………………………………………….281
Appendix H: Alberta Cancer Registry Cover Letter…………………………………………………….283
Appendix I: Participant Screening Sheet……………………………………………………………………..285
Appendix J: Informed Consent……………………………………………………………………………………288

Appendix K: Pretest Instructions………………………………………………………………………………..297
Appendix L: Intervention Tracking Sheet……………………………………………………………………301
Appendix M: Baseline Self-Report Questionnaire………………………………………………………..309
Appendix N: Postintervention Self-Report Questionnaire – Usual Care Group …………….329
Appendix O: Postintervention Self-Report Questionnaire – HIIT Group ……………………..344
Appendix P: 3-Month Follow-Up Self-Report Questionnaire – Combined…………………….363

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