Daniel A Galvão1, Nigel Spry2, James Denham3, Dennis R Taaffe4, Prue Cormie5, David Joseph2, David S Lamb6, Suzanne K Chambers7, Robert U Newton5. 1. Edith Cowan University Health and Wellness Institute, Joondalup, WA, Australia. Electronic address: d.galvao@ecu.edu.au. 2. Edith Cowan University Health and Wellness Institute, Joondalup, WA, Australia; Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia; Faculty of Medicine, University of Western Australia, Nedlands, WA, Australia. 3. School of Medicine and Public Health, University of Newcastle, NSW, Australia; Newcastle Mater Hospital, Newcastle, NSW, Australia. 4. Edith Cowan University Health and Wellness Institute, Joondalup, WA, Australia; School of Environmental and Life Sciences, University of Newcastle, NSW, Australia. 5. Edith Cowan University Health and Wellness Institute, Joondalup, WA, Australia. 6. University of Otago, Wellington, New Zealand. 7. Edith Cowan University Health and Wellness Institute, Joondalup, WA, Australia; Griffith Health Institute, Griffith University, Gold Coast, Australia; Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, Australia.
Abstract
BACKGROUND: Long-term prostate cancer (PCa) survivors are at increased risk for comorbidities and physical deconditioning. OBJECTIVE: To determine the effectiveness of a year-long randomised controlled trial of exercise training in PCa survivors >5 yr postdiagnosis on physical functioning. DESIGN, SETTING, AND PARTICIPANTS: Between 2010 and 2011, 100 long-term PCa survivors from Trans-Tasman Radiation Oncology Group 03.04 Randomised Androgen Deprivation and Radiotherapy previously treated with androgen-deprivation therapy and radiation therapy were randomly assigned to 6 mo of supervised exercise followed by 6 mo of a home-based maintenance programme (n=50) or printed educational material about physical activity (n=50) for 12 mo across 13 university-affiliated exercise clinics in Australia and New Zealand. INTERVENTION: Supervised resistance and aerobic exercise or printed educational material about physical activity. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary end point was a 400-m walk as a measure of cardiovascular fitness. Secondary end points were physical function, patient-reported outcomes, muscle strength, body composition, and biomarkers. Analysis of covariance was used to compare outcomes for groups at 6 and 12 mo adjusted for baseline values. RESULTS AND LIMITATIONS: Participants undergoingsupervised exercise showed improvement in cardiorespiratory fitness performance at 6 mo (-19 s [p=0.029]) and 12 mo (-13 s [p=0.028]) and better lower-body physical function across the 12-mo period (p<0.01). Supervised exercise also improved self-reported physical functioning at 6 (p=.006) and 12 mo (p=0.002), appendicular skeletal muscle at 6 mo (p=0.019), and objective measures of muscle strength at 6 and 12 mo (p<0.050). Limitations included the restricted number of participants undertaking body composition assessment, no blinding to group assignment for physical functioning measures, and inclusion of well-functioning individuals. CONCLUSIONS:Supervised exercise training in long-term PCa survivors is more effective than physical activity educational material for increasing cardiorespiratory fitness, physical function, muscle strength, and self-reported physical functioning at 6 mo. Importantly, these benefits were maintained in the long term with a home-based programme with follow-up at 12 mo. CLINICAL TRIAL REGISTRY: The effect of an exercise intervention on cardiovascular and metabolic risk factors in prostate cancer patients from the RADAR study, ACTRN: ACTRN12609000729224.
RCT Entities:
BACKGROUND: Long-term prostate cancer (PCa) survivors are at increased risk for comorbidities and physical deconditioning. OBJECTIVE: To determine the effectiveness of a year-long randomised controlled trial of exercise training in PCa survivors >5 yr postdiagnosis on physical functioning. DESIGN, SETTING, AND PARTICIPANTS: Between 2010 and 2011, 100 long-term PCa survivors from Trans-Tasman Radiation Oncology Group 03.04 Randomised Androgen Deprivation and Radiotherapy previously treated with androgen-deprivation therapy and radiation therapy were randomly assigned to 6 mo of supervised exercise followed by 6 mo of a home-based maintenance programme (n=50) or printed educational material about physical activity (n=50) for 12 mo across 13 university-affiliated exercise clinics in Australia and New Zealand. INTERVENTION: Supervised resistance and aerobic exercise or printed educational material about physical activity. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary end point was a 400-m walk as a measure of cardiovascular fitness. Secondary end points were physical function, patient-reported outcomes, muscle strength, body composition, and biomarkers. Analysis of covariance was used to compare outcomes for groups at 6 and 12 mo adjusted for baseline values. RESULTS AND LIMITATIONS: Participants undergoing supervised exercise showed improvement in cardiorespiratory fitness performance at 6 mo (-19 s [p=0.029]) and 12 mo (-13 s [p=0.028]) and better lower-body physical function across the 12-mo period (p<0.01). Supervised exercise also improved self-reported physical functioning at 6 (p=.006) and 12 mo (p=0.002), appendicular skeletal muscle at 6 mo (p=0.019), and objective measures of muscle strength at 6 and 12 mo (p<0.050). Limitations included the restricted number of participants undertaking body composition assessment, no blinding to group assignment for physical functioning measures, and inclusion of well-functioning individuals. CONCLUSIONS: Supervised exercise training in long-term PCa survivors is more effective than physical activity educational material for increasing cardiorespiratory fitness, physical function, muscle strength, and self-reported physical functioning at 6 mo. Importantly, these benefits were maintained in the long term with a home-based programme with follow-up at 12 mo. CLINICAL TRIAL REGISTRY: The effect of an exercise intervention on cardiovascular and metabolic risk factors in prostate cancerpatients from the RADAR study, ACTRN: ACTRN12609000729224.
Authors: T Hasenoehrl; M Keilani; T Sedghi Komanadj; M Mickel; M Margreiter; M Marhold; R Crevenna Journal: Support Care Cancer Date: 2015-05-24 Impact factor: 3.603
Authors: Maria C Swartz; Zakkoyya H Lewis; Elizabeth J Lyons; Kristofer Jennings; Addie Middleton; Rachel R Deer; Demi Arnold; Kaitlin Dresser; Kenneth J Ottenbacher; James S Goodwin Journal: Arch Phys Med Rehabil Date: 2017-04-17 Impact factor: 3.966
Authors: Claire H Pernar; Katja Fall; Jennifer R Rider; Sarah C Markt; Hans-Olov Adami; Sven-Olof Andersson; Unnur Valdimarsdottir; Ove Andrén; Lorelei A Mucci Journal: Clin Genitourin Cancer Date: 2017-05-31 Impact factor: 2.872
Authors: Kerri M Winters-Stone; Karen S Lyons; Jessica Dobek; Nathan F Dieckmann; Jill A Bennett; Lillian Nail; Tomasz M Beer Journal: J Cancer Surviv Date: 2015-12-29 Impact factor: 4.442
Authors: Daniel A Galvão; Dennis R Taaffe; Nigel Spry; Robert A Gardiner; Renea Taylor; Gail P Risbridger; Mark Frydenberg; Michelle Hill; Suzanne K Chambers; Phillip Stricker; Tom Shannon; Dickon Hayne; Eva Zopf; Robert U Newton Journal: Nat Rev Urol Date: 2016-03-08 Impact factor: 14.432
Authors: J Uth; T Hornstrup; J F Christensen; K B Christensen; N R Jørgensen; J F Schmidt; K Brasso; M D Jakobsen; E Sundstrup; L L Andersen; M Rørth; J Midtgaard; P Krustrup; E W Helge Journal: Osteoporos Int Date: 2015-11-16 Impact factor: 4.507