Timing of exercise for muscle strength and physical function in men initiating ADT for prostate cancer
Open Access
- 1 September 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Prostate Cancer and Prostatic Diseases
- Vol. 23 (3), 457-464
- https://doi.org/10.1038/s41391-019-0200-z
Abstract
Background Androgen deprivation therapy (ADT) in men with prostate cancer (PCa) results in adverse effects, including reduced muscle strength and physical function, potentially compromising daily functioning. We examined whether it was more efficacious to commence exercise at the onset of ADT rather than later in treatment to counter declines in strength and physical function. Methods One-hundred-and-four men with PCa (68.3 +/- 7.0 years) initiating ADT were randomised to immediate exercise (IMX, n = 54) or delayed exercise (DEL, n = 50) for 12 months. IMX comprised 6 months of supervised resistance/aerobic/impact exercise initiated at the onset of ADT with a 6-month follow-up. DEL comprised 6 months of usual care followed by 6 months of resistance/aerobic/impact exercise. Upper and lower body muscle strength and physical function were assessed at baseline, 6 and 12 months. Results There was a significant difference for all strength measures at 6 months favouring IMX (P < 0.001), with net differences in leg press, seated row and chest press strength of 19.9 kg (95% CI, 12.3-27.5 kg), 5.6 kg (3.8-7.4 kg) and 4.3 kg (2.7-5.8 kg), respectively. From 7 to 12 months, DEL increased in all strength measures (P < 0.001), with no differences between groups at 12 months. Similarly, physical function improved (P < 0.001) in IMX compared with DEL at 6 months for the 6-m fast walk (-0.2, 95% CI -0.3 to -0.1 s), 400-m walk (-9.7, -14.8 to -4.6 s), stair climb (-0.4, -0.6 to -0.2 s) and chair rise (-1.0, -1.4 to -0.7 s), with no differences between groups by 12 months, except for the 6-m fast walk (P < 0.001). Conclusion Exercise either at the onset or after 6 months of ADT preserves/enhances muscle strength and physical function. However, to avoid initial treatment-related adverse effects on strength and function, exercise therapy should be implemented with initiation of ADT.Funding Information
- Department of Health | National Health and Medical Research Council (1029901)
This publication has 32 references indexed in Scilit:
- Can exercise ameliorate treatment toxicity during the initial phase of testosterone deprivation in prostate cancer patients? Is this more effective than delayed rehabilitation?BMC Cancer, 2012
- Combined Resistance and Aerobic Exercise Program Reverses Muscle Loss in Men Undergoing Androgen Suppression Therapy for Prostate Cancer Without Bone Metastases: A Randomized Controlled TrialJournal of Clinical Oncology, 2010
- Added Value of Physical Performance Measures in Predicting Adverse Health‐Related Events: Results from the Health, Aging and Body Composition StudyJournal of the American Geriatrics Society, 2009
- Reduced muscle strength and functional performance in men with prostate cancer undergoing androgen suppression: a comprehensive cross-sectional investigationProstate Cancer and Prostatic Diseases, 2008
- Falls and Physical Performance Deficits in Older Patients With Prostate Cancer Undergoing Androgen Deprivation TherapyUrology, 2008
- Association between muscular strength and mortality in men: prospective cohort studyBMJ, 2008
- Physical Function in Men With Prostate Cancer on Androgen Deprivation TherapyPTJ: Physical Therapy & Rehabilitation Journal, 2007
- Adverse effects to quality of life arising from treatment can recover with intermittent androgen suppression in men with prostate cancerEuropean Journal of Cancer, 2006
- Estimating Cardiorespiratory Fitness in Well‐Functioning Older Adults: Treadmill Validation of the Long Distance Corridor WalkJournal of the American Geriatrics Society, 2005
- Resistance Exercise Dosage in Older Adults: Single‐ Versus Multiset Effects on Physical Performance and Body CompositionJournal of the American Geriatrics Society, 2005