{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:33:35Z","timestamp":1787236415667,"version":"build-2736575974"},"reference-count":36,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Heart rate recovery (HRR) is an important indicator of cardiovascular autonomic function, yet evidence in women with breast cancer remains limited. This study aimed to analyze heart rate recovery during the first two minutes following a maximal exercise test and to examine its association with age, weekly physical activity, and oncological treatment duration using wearable technology. A cross-sectional design was applied in 22 women with breast cancer enrolled in an oncological exercise program. Participants performed a maximal treadmill test using the Modified Bruce Protocol, after which the mean heart rate was recorded across eight 15 s recovery intervals using a wearable chest-strap heart rate sensor integrated with an inertial device (WIMU PRO). Results showed a progressive and significant decrease in heart rate during recovery, with the first statistically significant pairwise difference emerging at 45\u201360 s post-exercise compared to the initial recovery interval (p &lt; 0.05), within the context of a continuous HR decline. Regression analysis identified weekly physical activity hours (\u03b2 = \u22120.281, p = 0.013) and oncological treatment duration (\u03b2 = \u22120.245, p = 0.038) as significant predictors of mean heart rate recovery, explaining 4.8% of the variance, while age was not significantly associated (\u03b2 = 0.049, p = 0.622). In conclusion, a differentiated recovery pattern emerged at approximately 45\u201360 s post-exercise, with weekly physical activity and oncological treatment duration as determinants. These findings support the use of wearable-based monitoring to inform individualized exercise prescription in women with breast cancer.<\/jats:p>","DOI":"10.3390\/s26061996","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T09:48:42Z","timestamp":1774259322000},"page":"1996","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Wearable-Based Assessment of Cardiac Recovery After a Modified Bruce Test in Women with Breast Cancer: Role of Physical Activity and Treatment Duration"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4096-7183","authenticated-orcid":false,"given":"Carlos","family":"Navarro-Mart\u00ednez","sequence":"first","affiliation":[{"name":"Education, Diversity and Quality Research Group, Faculty of Education, University of Murcia, Campus de Espinardo, 30100 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Ferrer-Artero","sequence":"additional","affiliation":[{"name":"BioVetMed & SportSci Research Group, Faculty of Sport Sciences, University of Murcia, 30720 San Javier, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8198-6603","authenticated-orcid":false,"given":"Keven","family":"Santamaria-Guzman","sequence":"additional","affiliation":[{"name":"Locomotor and Movement Control Laboratory, School of Kinesiology, Auburn University, Auburn, AL 36849, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9091-0897","authenticated-orcid":false,"given":"Jos\u00e9","family":"Pino-Ortega","sequence":"additional","affiliation":[{"name":"BioVetMed & SportSci Research Group, Faculty of Sport Sciences, University of Murcia, 30720 San Javier, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Nardin, S., Mora, E., Varughese, F.M., D\u2019Avanzo, F., Vachanaram, A.R., Rossi, V., Saggia, C., Rubinelli, S., and Gennari, A. (2020). Breast Cancer Survivorship, Quality of Life, and Late Toxicities. Front. Oncol., 10.","DOI":"10.3389\/fonc.2020.00864"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1038\/bjc.2014.568","article-title":"Physical Function as a Prognostic Biomarker among Cancer Survivors","volume":"112","author":"Brown","year":"2015","journal-title":"Br. J. Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"80","DOI":"10.30773\/pi.2020.0286","article-title":"Factors Associated with the Quality of Life of Patients with Cancer Undergoing Radiotherapy","volume":"18","author":"Seol","year":"2021","journal-title":"Psychiatry Investig."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Chen, G., Zhou, H., Wang, C., Qin, R., Yang, Q., Hou, Y., Zhang, M., Zhang, C., Wang, N., and Feng, Y. (2025). Chemotherapy Cardiotoxicity Research in Cancer Patients: A Bibliometric and Visual Analysis (1994\u20132024). Front. Oncol., 15.","DOI":"10.3389\/fonc.2025.1502361"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"135","DOI":"10.15386\/cjmed-339","article-title":"Chemotherapy-Induced Cardiotoxicity: Pathophysiology and Prevention","volume":"87","author":"Csapo","year":"2014","journal-title":"Med. Pharm. Rep."},{"key":"ref_6","first-page":"2","article-title":"Beneficios Del Ejercicio F\u00edsico En Mujeres Diagnosticadas de C\u00e1ncer de Seno Invasivo. Una Revisi\u00f3n Sistem\u00e1tica","volume":"3","author":"Pulgar","year":"2023","journal-title":"MLS Sport Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.breast.2018.04.009","article-title":"Physical Activity Levels after Treatment for Breast Cancer: Two-Year Follow-Up","volume":"40","author":"Geraerts","year":"2018","journal-title":"Breast"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1503\/cmaj.051073","article-title":"Effects of Exercise on Breast Cancer Patients and Survivors: A Systematic Review and Meta-Analysis","volume":"175","author":"McNeely","year":"2006","journal-title":"Can. Med. Assoc. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"40","DOI":"10.3747\/co.24.3376","article-title":"Exercise for People with Cancer: A Clinical Practice Guideline","volume":"24","author":"Segal","year":"2017","journal-title":"Curr. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1249\/MSS.0000000000003385","article-title":"The Association between Cardiorespiratory Fitness and the Risk of Breast Cancer in Women","volume":"56","author":"Katsaroli","year":"2024","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e005505","DOI":"10.1161\/JAHA.117.005505","article-title":"Heart Rate Recovery and Risk of Cardiovascular Events and All-Cause Mortality: A Meta-Analysis of Prospective Cohort Studies","volume":"6","author":"Qiu","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Cozgarea, A., Cozma, D., Teodoru, M., Laz\u0103r-H\u00f6cher, A.-I., Cirin, L., Faur-Grigori, A.-A., Laz\u0103r, M.-A., Cri\u0219an, S., Gai\u021b\u0103, D., and Luca, C.-T. (2024). Heart Rate Recovery: Up to Date in Heart Failure\u2014A Literature Review. J. Clin. Med., 13.","DOI":"10.3390\/jcm13113328"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/j.ijcard.2016.10.057","article-title":"Methods of Assessment of the Post-Exercise Cardiac Autonomic Recovery: A Methodological Review","volume":"227","author":"Bartels","year":"2017","journal-title":"Int. J. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.1016\/S0735-1097(01)01652-7","article-title":"Heart rate recovery: Validation and methodologic issues","volume":"38","author":"Shetler","year":"2001","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e18694","DOI":"10.2196\/18694","article-title":"Reliability and Validity of Commercially Available Wearable Devices for Measuring Steps, Energy Expenditure, and Heart Rate: Systematic Review","volume":"8","author":"Fuller","year":"2020","journal-title":"JMIR mHealth uHealth"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.sjbs.2017.05.009","article-title":"Cardio Respiratory Response: Validation of New Modifications of Bruce Protocol for Exercise Testing and Training in Elite Saudi Triathlon and Soccer Players","volume":"26","author":"Badawy","year":"2019","journal-title":"Saudi J. Biol. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"552","DOI":"10.7326\/0003-4819-132-7-200004040-00007","article-title":"Heart Rate Recovery after Submaximal Exercise Testing as a Predictor of Mortality in a Cardiovascularly Healthy Cohort","volume":"132","author":"Cole","year":"2000","journal-title":"Ann. Intern. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1002\/cncr.29899","article-title":"Randomized Trial of a Physical Activity Intervention in Women with Metastatic Breast Cancer","volume":"122","author":"Ligibel","year":"2016","journal-title":"Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1016\/S0735-1097(03)00833-7","article-title":"Heart rate recovery after exercise is a predictor of mortality, independent of the angiographic severity of coronary disease","volume":"42","author":"Vivekananthan","year":"2003","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"161","DOI":"10.3233\/BD-249005","article-title":"Physical Activity and Quality of Life in Breast Cancer Survivors","volume":"43","author":"Agussalim","year":"2024","journal-title":"Breast Dis."},{"key":"ref_21","first-page":"6745","article-title":"The Importance of Physical Exercise in Cardiovascular Fitness in Breast Cancer Survivors. A Cross-Sectional Study: Women in Motion 2.0","volume":"30","author":"Castellanos","year":"2022","journal-title":"Support. Care Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Marzano-Felisatti, J.M., De Lucca, L., Priego-Quesada, J.I., and Pino-Ortega, J. (2024). Heart Rate Measurement Accuracy During Intermittent Efforts Under Laboratory Conditions: A Comparative Analysis Between Chest Straps and Armband. Appl. Sci., 14.","DOI":"10.3390\/app142411872"},{"key":"ref_23","first-page":"81","article-title":"Validity of WIMU PRO inertial device to register heart rate variable in a field test","volume":"7","year":"2018","journal-title":"Sport Tk-Rev. Euroam. Cienc. Deporte"},{"key":"ref_24","first-page":"323","article-title":"Exercise testing of patients with coronary heart disease. Principles and normal standards for evaluation","volume":"3","author":"Bruce","year":"1971","journal-title":"Ann. Clin. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s40279-023-01908-y","article-title":"Revisiting the \u2018Whys\u2019 and \u2018Hows\u2019 of the Warm-Up: Are We Asking the Right Questions?","volume":"54","author":"Afonso","year":"2024","journal-title":"Sports Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1530","DOI":"10.70252\/XQRC2496","article-title":"Effects of Different Warm-up Protocols on the Cardiopulmonary Responses to Exercise Testing in Youth","volume":"17","author":"Faigenbaum","year":"2024","journal-title":"Int. J. Exerc. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"12011","DOI":"10.1038\/s41598-021-91565-w","article-title":"Independent Influence of Age on Heart Rate Recovery after Flywheel Exercise in Trained Men and Women","volume":"11","author":"Zubac","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1002\/cam4.1916","article-title":"Case-control Study of Heart Rate Abnormalities across the Breast Cancer Survivorship Continuum","volume":"8","author":"Groarke","year":"2019","journal-title":"Cancer Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1186\/s40064-015-1179-0","article-title":"Exercise Training Improves Heart Rate Recovery in Women with Breast Cancer","volume":"4","author":"Giallauria","year":"2015","journal-title":"SpringerPlus"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.hrtlng.2017.06.001","article-title":"The Yale Fitness Intervention Trial in Female Cancer Survivors: Cardiovascular and Physiological Outcomes","volume":"46","author":"Knobf","year":"2017","journal-title":"Heart Lung"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Campana, N., Fazzini, L., Donisi, C., Nava, A., Migliari, M., Deidda, M., Pretta, A., Scartozzi, M., and Cadeddu Dessalvi, C. (2025). Exercise Prescription in Cardio-Oncology. J. Clin. Med., 14.","DOI":"10.3390\/jcm14113724"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Lav\u00edn-P\u00e9rez, A.M., Collado-Mateo, D., Hinojo Gonz\u00e1lez, C., Batista, M., Mayo, X., Ruis\u00e1nchez Villar, C., and Jim\u00e9nez, A. (2023). An Online Home-Based Exercise Program Improves Autonomic Dysfunction in Breast Cancer Survivors. Front. Physiol., 14.","DOI":"10.3389\/fphys.2023.1256644"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1007\/s00432-025-06234-6","article-title":"[M1.1][CNM1.2]. Cardiac Autonomic Dysfunction in Patients with Cancer: Exploring the Role of Physical Exercise","volume":"151","author":"Borsati","year":"2025","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e20240517","DOI":"10.1590\/1806-9282.20240517","article-title":"The Effects of Trastuzumab Therapy on Endothelial Functions of Breast Cancer Patients","volume":"70","author":"Alp","year":"2024","journal-title":"Rev. Assoc. Med. Bras."},{"key":"ref_35","first-page":"555","article-title":"Changes in Cardiac Autonomic Modulation in Women with Breast Cancer Using Aromatase Inhibitors and the Relation with Biochemical Variables","volume":"112","author":"Gonzaga","year":"2019","journal-title":"Arq. Bras. Cardiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1007\/s12012-025-09986-2","article-title":"Anthracyclines-Induced Vascular Endothelial Dysfunction in Cancer Patients and Survivors Using Brachial Flow-Mediated Dilation (FMD) Tool: A Systematic Review and Meta-Analysis","volume":"25","author":"Kattan","year":"2025","journal-title":"Cardiovasc. Toxicol."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/6\/1996\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T09:57:57Z","timestamp":1774259877000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/6\/1996"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,23]]},"references-count":36,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["s26061996"],"URL":"https:\/\/doi.org\/10.3390\/s26061996","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,23]]}}}