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Exercise Mode Specificity for Preserving Spine and Hip Bone Mineral Density in Prostate Cancer Patients.

Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, AUSTRALIA. School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, AUSTRALIA. Institute of Human Performance, The University of Hong Kong, HONG KONG. School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, AUSTRALIA. Genesis CancerCare, Joondalup, WA, AUSTRALIA. Faculty of Medicine, University of Western Australia, Nedlands, WA, AUSTRALIA. Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, AUSTRALIA. Menzies Health Institute Queensland, Griffith University, Gold Coast, AUSTRALIA. Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, QLD, AUSTRALIA. Prostate Cancer Foundation of Australia, Sydney, NSW, AUSTRALIA. Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, AUSTRALIA. School of Psychology and Exercise Science, Murdoch University, Murdoch, WA, AUSTRALIA. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, SWEDEN.

Medicine and science in sports and exercise. 2019;(4):607-614
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Abstract

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.

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