{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:24:07Z","timestamp":1791923047287,"version":"4.3.4"},"reference-count":52,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Exercise has been shown to improve mental well\u2010being and health\u2010related quality of life (HRQoL) in breast cancer survivors. However, there is no evidence on the effects of online interventions tailored using heart rate variability (HRV).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study analyzed the effects of online high\u2010intensity interval and strength training, guided daily by autonomic modulation, compared to pre\u2010planned moderate to high\u2010intensity concurrent training and control, on HRQoL, pain, fatigue, anxiety, depression, life satisfaction, self\u2010esteem, and fear of movement in breast cancer survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 16\u2010week randomized controlled trial was conducted with 54 participants assigned to HRV\u2010guided exercise, pre\u2010planned exercise, or usual care. Participants trained aerobic and strength three times per week under real\u2010time online supervision. Intensity was adjusted based on HRV for the HRV\u2010guided group. HRQoL, anxiety, depression, life satisfaction, self\u2010esteem and fear of movement were assessed pre\u2010 and post\u2010intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant time\u2010by\u2010group interactions were found for HRQoL functional domains (physical\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.004, role\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.005, emotional\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.013, social\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.001) and symptoms (fatigue\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001, pain\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001, dyspnea\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.004, insomnia\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.012, constipation\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.014), as well as depression (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), anxiety (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002), life satisfaction (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.003), self\u2010esteem (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.024), and fear of movement (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.015). HRV\u2010guided exercise led to greater improvements, while the control group worsened. Moreover, the exploratory analysis suggested a higher degree of interconnected changes in the HRV\u2010guided group, and that dyspnea and fatigue might be the variables most strongly connected with anxiety, depression, and functioning\u2010related variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Individualized online concurrent exercise, especially autonomic modulation\u2010guided, improves HRQoL and mental health in breast cancer survivors, representing a promising personalized rehabilitation strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.70348","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T01:39:54Z","timestamp":1764812394000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effects of Individualized High\u2010Intensity Online Concurrent Exercise Guided by Autonomic Modulation on the Mental Health and Quality of Life of Breast Cancer Survivors"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9357-9987","authenticated-orcid":false,"given":"Ana Myriam","family":"Lav\u00edn\u2010P\u00e9rez","sequence":"first","affiliation":[{"name":"Sport Sciences Research Centre King Juan Carlos University  Madrid Spain"},{"name":"GO Fit LAB GO Fit Life Science and Technology, S.A.  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Collado\u2010Mateo","sequence":"additional","affiliation":[{"name":"Sport Sciences Research Centre King Juan Carlos University  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In\u00e9s","family":"Nieto","sequence":"additional","affiliation":[{"name":"Sport Sciences Research Centre King Juan Carlos University  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi\u00e1n","family":"Mayo","sequence":"additional","affiliation":[{"name":"Sport Sciences Research Centre King Juan Carlos University  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Hinojo","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Oncology Department Hospital Universitario Marqu\u00e9s de Valdecilla  Santander Spain"},{"name":"Instituto de Investigaci\u00f3n Marqu\u00e9s de Valdecilla (IDIVAL)  Santander Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"de Juan Ferr\u00e9","sequence":"additional","affiliation":[{"name":"Oncology Department Hospital Universitario Marqu\u00e9s de Valdecilla  Santander Spain"},{"name":"Instituto de Investigaci\u00f3n Marqu\u00e9s de Valdecilla (IDIVAL)  Santander Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso","family":"Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Sport Sciences Research Centre King Juan Carlos University  Madrid Spain"},{"name":"GO Fit LAB GO Fit Life Science and Technology, S.A.  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2022.08.010"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2022.102375"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.4103\/apjon.apjon_65_20"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003504"},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","unstructured":"LeeS. K. ParkS. andParkS. M. \u201cDepression and Long\u2010term Mortality Among 5\u2010year Breast Cancer Survivors in Korea: A Population\u2010Based Cohort Study \u201d (2024).","DOI":"10.21203\/rs.3.rs-3991118\/v1"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010020\u201007294\u20102"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnss.2022.12.006"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.2196\/45212"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2022.102111"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15010324"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010021\u201094476\u2010y"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anr.2023.11.001"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2025.104718"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1249\/mss.0000000000002116"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1519\/jsc.0000000000004270"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2014.03.011"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.4258\/hir.2023.29.4.352"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18042023"},{"key":"e_1_2_12_20_1","first-page":"1","article-title":"Development and Validation of the Spanish Version of the PADEX Checklist to Promote Adherence to Physical Exercise in People With Long\u2010Term Health Conditions and Older Adults","author":"Lav\u00edn\u2010P\u00e9rez A. 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