Teresa Lam1,2,3, Birinder Cheema4, Amy Hayden5,6, Stephen R Lord7, Howard Gurney6, Shivanjini Gounden4, Navneeta Reddy8,9, Haleh Shahidipour8,9,10,11, Scott Read8,9, Glenn Stone12, Mark McLean8,9, Vita Birzniece8,9,10,11,13. 1. School of Medicine, Western Sydney University, Penrith, NSW, Australia. Teresa.Lam@health.nsw.gov.au. 2. Department of Diabetes and Endocrinology, Westmead Hospital, Sydney, NSW, 2148, Australia. Teresa.Lam@health.nsw.gov.au. 3. Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, NSW, Australia. Teresa.Lam@health.nsw.gov.au. 4. School of Science and Health, Western Sydney University, Penrith, NSW, Australia. 5. Department of Radiation Oncology, Blacktown Hospital, Blacktown, NSW, Australia. 6. Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW, Australia. 7. NeuRA, University of New South Wales, Sydney, NSW, Australia. 8. School of Medicine, Western Sydney University, Penrith, NSW, Australia. 9. Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, NSW, Australia. 10. School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia. 11. Translational Health Research Institute, Penrith, NSW, Australia. 12. School of Computing, Engineering and Mathematics, Western Sydney University, Penrith, NSW, Australia. 13. Garvan Institute of Medical Research, Sydney, NSW, Australia.
Abstract
INTRODUCTION:Androgen deprivation therapy (ADT) has detrimental effects on body composition, metabolic health, physical functioning, bone mineral density (BMD) and health-related quality of life (HRQOL) in men with prostate cancer. We investigated whether a 12-month home-based progressive resistance training (PRT) programme, instituted at the start of ADT, could prevent these adverse effects. METHODS:Twenty-five patients scheduled to receive at least 12 months of ADT were randomly assigned to either usual care (UC) (n = 12) or PRT (n = 13) starting immediately after their first ADT injection. Body composition, body cell mass (BCM; a functional component of lean body mass), BMD, physical function, insulin sensitivity and HRQOL were measured at 6 weeks and 6 and 12 months. Data were analysed by a linear mixed model. RESULTS: ADT had a negative impact on body composition, BMD, physical function, glucose metabolism and HRQOL. At 12 months, the PRT group had greater reductions in BCM by - 1.9 ± 0.8 % (p = 0.02) and higher gains in fat mass by 3.1 ± 1.0 % (p = 0.002), compared to the UC group. HRQOL domains were maintained or improved in the PRT versus UC group at 6 weeks (general health, p = 0.04), 6 months (vitality, p = 0.02; social functioning, p = 0.03) and 12 months (mental health, p = 0.01; vitality, p = 0.02). A significant increase in the Matsuda Index in the PRT versus UC group was noted at 6 weeks (p = 0.009) but this difference was not maintained at subsequent timepoints. Between-group differences favouring the PRT group were also noted for physical activity levels (step count) (p = 0.02). No differences in measures of BMD or physical function were detected at any time point. CONCLUSION: A home-based PRT programme instituted at the start of ADT may counteract detrimental changes in body composition, improve physical activity and mental health over 12 months. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry, ACTRN12616001311448.
RCT Entities:
INTRODUCTION: Androgen deprivation therapy (ADT) has detrimental effects on body composition, metabolic health, physical functioning, bone mineral density (BMD) and health-related quality of life (HRQOL) in men with prostate cancer. We investigated whether a 12-month home-based progressive resistance training (PRT) programme, instituted at the start of ADT, could prevent these adverse effects. METHODS: Twenty-five patients scheduled to receive at least 12 months of ADT were randomly assigned to either usual care (UC) (n = 12) or PRT (n = 13) starting immediately after their first ADT injection. Body composition, body cell mass (BCM; a functional component of lean body mass), BMD, physical function, insulin sensitivity and HRQOL were measured at 6 weeks and 6 and 12 months. Data were analysed by a linear mixed model. RESULTS:ADT had a negative impact on body composition, BMD, physical function, glucose metabolism and HRQOL. At 12 months, the PRT group had greater reductions in BCM by - 1.9 ± 0.8 % (p = 0.02) and higher gains in fat mass by 3.1 ± 1.0 % (p = 0.002), compared to the UC group. HRQOL domains were maintained or improved in the PRT versus UC group at 6 weeks (general health, p = 0.04), 6 months (vitality, p = 0.02; social functioning, p = 0.03) and 12 months (mental health, p = 0.01; vitality, p = 0.02). A significant increase in the Matsuda Index in the PRT versus UC group was noted at 6 weeks (p = 0.009) but this difference was not maintained at subsequent timepoints. Between-group differences favouring the PRT group were also noted for physical activity levels (step count) (p = 0.02). No differences in measures of BMD or physical function were detected at any time point. CONCLUSION: A home-based PRT programme instituted at the start of ADT may counteract detrimental changes in body composition, improve physical activity and mental health over 12 months. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry, ACTRN12616001311448.
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