Table 2

Content of the supervised physical exercise training programme in the intervention group

Frequency	Intensity	Time	Type
Three times a week	Aerobic interval training, consisting of four intervals of alternating effort performed on a cycle ergometer: 4 min of low-intensity exercise, defined as 30% of the workload achieved at VO₂peak. 2–3 min of high-intensity exercise, defined as 90% of the workload achieved at VO₂peak.*	24–28 min	Aerobic interval training
Two times a week	During neoadjuvant treatment: Week 1–3: consisting of 20 min on a cycle ergometer and 10 min on a different aerobic machine, corresponding to 30% of the heart rate reserve. Week 4–6: consisting of 20 min on a cycle ergometer and 10 min on a different aerobic machine, corresponding to 40% of the heart rate reserve. Week 7–9: consisting of 20 min on a cycle ergometer and 10 min on a different aerobic machine, corresponding to 50% of the heart rate reserve. Week 10–12 (and further): consisting of 20 min on a cycle ergometer and 10 min on a different aerobic machine, corresponding to 60% of the heart rate reserve.	30 min	Aerobic training
Two times a week	Resistance training, consisting of training six large muscle groups (leg press, bench press or chest press, abdominal crunch, pull over, low row and step up)† in two sets: Week 1: maximal 15 repetitions at ~65% of 1RM per set. Week 2: maximal 12 repetitions at ~70% of 1RM per set (weight week 1+10%). Week 3: maximal 10 repetitions at ~75% of 1RM per set (weight week 2+10%). From week 4 maximal 10 repetitions per set.‡	~20 min	Resistance training
One time a week	Progressive muscle relaxation techniques.35	~20 min	Relaxation exercises

*Further tailoring is done by the physical therapists: if a patient is not able to complete the high-intensity interval, the intensity will be reduced by 10%. The intensity can be reduced further in steps of 10% until the patient can complete all four high-intensity intervals. If a patient is able to complete all high-intensity intervals, moderate and high intensity will be increased by 10%.94 During neoadjuvant treatment95: if a patient scores below a Borg score of 12 intensity is increased, if a patient scores above a Borg score of 15 intensity is decreased.
†Physical therapists can offer alternative resistance exercises targeting the same muscle group to accommodate a patient’s abilities and preferences.
‡If the patient is able to do two repetitions more than planned, the load will be increased by 10%. The load will be decreased by 10% if the number of repetitions the patient achieves is two less than the planned number of repetitions.
1RM, one-repetition maximum; CPET, cardiopulmonary exercise test; VO₂peak, oxygen uptake at peak exercise.