TY - JOUR
T1 - Exercise mode specificity for preserving spine and hip bone mineral density in prostate cancer patients
AU - Newton, Robert U.
AU - Galvão, Daniel A.
AU - Spry, Nigel
AU - Joseph, David
AU - Chambers, Suzanne K.
AU - Gardiner, Robert A.
AU - Wall, Brad A.
AU - Bolam, Kate A.
AU - Taaffe, Dennis R.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Purpose Androgen deprivation therapy (ADT) in men with prostate cancer (PCA) is associated with an array of adverse effects, including reduced bone mineral density (BMD) predisposing patients to increased fracture risk. Our purpose was to examine the effects of targeted exercise modes on BMD in men with PCA undergoing ADT. Methods Between 2009 and 2012, 154 PCA patients 43-90 yr old on ADT were randomized to exercise targeting the musculoskeletal system (impact loading + resistance training [ImpRes], n = 57) supervised for 12 months, cardiovascular and muscular systems (aerobic + resistance training, n = 50) supervised for 6 months followed by a 6-month home-based program, or delayed aerobic exercise (DelAer, n = 47) received exercise information for 6 months followed by 6 months of supervised aerobic exercise (stationary cycling). End points were lumbar spine, hip and whole-body BMD measured by dual-energy x-ray absorptiometry with secondary end points of lean and fat mass, appendicular skeletal muscle mass, and neuromuscular strength. ANOVA was used to compare the exercise groups with DelAer at 6 and 12 months. Results There was a between-group difference in BMD for ImpRes and DelAer at the spine (6 months, P = 0.039; 12 months, P = 0.035) and femoral neck (6 months, P = 0.050), with decline attenuated in ImpRes (-1.0% vs -2.0%). Compared with DelAer, ImpRes increased appendicular skeletal muscle at 6 months (0.3 kg, P = 0.045) and improved muscle strength at 6 and 12 months (P ≤ 0.012) by 9%-34%. A limitation was inclusion of well-functioning patients. Conclusion Combined impact loading and resistance exercise attenuates bone loss at the spine and enhances overall musculoskeletal function in PCA patients undergoing ADT.
AB - Purpose Androgen deprivation therapy (ADT) in men with prostate cancer (PCA) is associated with an array of adverse effects, including reduced bone mineral density (BMD) predisposing patients to increased fracture risk. Our purpose was to examine the effects of targeted exercise modes on BMD in men with PCA undergoing ADT. Methods Between 2009 and 2012, 154 PCA patients 43-90 yr old on ADT were randomized to exercise targeting the musculoskeletal system (impact loading + resistance training [ImpRes], n = 57) supervised for 12 months, cardiovascular and muscular systems (aerobic + resistance training, n = 50) supervised for 6 months followed by a 6-month home-based program, or delayed aerobic exercise (DelAer, n = 47) received exercise information for 6 months followed by 6 months of supervised aerobic exercise (stationary cycling). End points were lumbar spine, hip and whole-body BMD measured by dual-energy x-ray absorptiometry with secondary end points of lean and fat mass, appendicular skeletal muscle mass, and neuromuscular strength. ANOVA was used to compare the exercise groups with DelAer at 6 and 12 months. Results There was a between-group difference in BMD for ImpRes and DelAer at the spine (6 months, P = 0.039; 12 months, P = 0.035) and femoral neck (6 months, P = 0.050), with decline attenuated in ImpRes (-1.0% vs -2.0%). Compared with DelAer, ImpRes increased appendicular skeletal muscle at 6 months (0.3 kg, P = 0.045) and improved muscle strength at 6 and 12 months (P ≤ 0.012) by 9%-34%. A limitation was inclusion of well-functioning patients. Conclusion Combined impact loading and resistance exercise attenuates bone loss at the spine and enhances overall musculoskeletal function in PCA patients undergoing ADT.
KW - ANDROGEN DEPRIVATION THERAPY
KW - BONE
KW - EXERCISE
KW - IMPACT
KW - RESISTANCE
UR - http://www.scopus.com/inward/record.url?scp=85063008032&partnerID=8YFLogxK
U2 - 10.1249/MSS.0000000000001831
DO - 10.1249/MSS.0000000000001831
M3 - Article
C2 - 30395051
AN - SCOPUS:85063008032
VL - 51
SP - 607
EP - 614
JO - Medicine & Science in Sports & Exercise
JF - Medicine & Science in Sports & Exercise
SN - 0195-9131
IS - 4
ER -