Introduction
Patients, materials and methods
Results
Literature search
Risk of bias
Level of evidence
Study | Year | Level of evidence | Type of exercise intervention |
---|---|---|---|
Gazova et al. [47] | 2019 | IIb | RE only |
Galvao et al. [51] | 2018 | Ib | RE+AE+FLEX |
Taaffe et al. [50] | 2019 | Ib | RE+AE+IT vs. delayed RE+AE+IT |
Ndjavera et al. [48] | 2020 | Ib | RE+AE |
Newton et al. [49] | 2019 | Ib | RE+IT and RE+AE vs. delayed AE |
Independent articles
Study | Sample | Mean age ± SD (years) | Patient details/cancer treatment | Duration of intervention (weeks) | Exercise program details | Frequency, duration and intensity | Key findings/comments |
---|---|---|---|---|---|---|---|
Newton et al. [49] | Impact training and RE (IRE) n = 57 RE and AE (RAE, Clinic-based for the first 26 weeks, home-based for further 26 weeks) n = 50 Delayed AE (DAE, usual care for the first 26 weeks, non-impact AE for further 26 weeks) n = 47 | IRE 68.7 ± 9.3 RAE 69.1 ± 9.4 DAE 69.1 ± 8.4 | Men treated for localized prostate cancer including ongoing ADT initiated at least two months before enrollment | 52 | RE: 2–4 sets of 6–12 repetitions (chest press, seated row, lat pull-down, leg press, leg extension, and leg curls). Bodyweight and resistance bands in the second half of the study for RAE AE: 20–30 min for RAE (various modalities), 30–40 min for DAE IT (hopping, leaping and drop jumping) FLEX (only DAE, modality not specified) | 2 ×/week supervised exercise, 1 h/session IRE: 10 min warm-up RE at 12RM progressing to 6RM IT (mostly sets of 10 repetitions) 5 min cool-down Additional home-based IT 2 ×/week RAE: 10 min warm-up RE at 12RM progressing to 6RM AE at 70–90% of eHRmax 5 min cool-down Additional home-based AE to meet 150 min/week (same intensity) DAE: AE at approximately 70% of eHRmax | Primary outcome: Bone mineral density: Significantly lesser decrease for IRE in the lumbar spine at 26 and 52 weeks, femoral neck at 26 weeks Secondary outcomes: ↑ Muscle strength (IRE at 26 and 52 weeks, RAE at 26 weeks) ↑ Appendicular skeletal muscle mass (IRE at 26 weeks) ↔ Fat mass ↔ Lean mass Comparison with DAE |
Taaffe et al. [50] | Immediate EI (IEI) n = 54 Delayed EI (DEI, usual care for the first 26 weeks) n = 50 | Immediate EI 69.0 ± 6.3 Delayed EI 67.5 ± 7.7 | Men treated for localized prostate cancer beginning ADT | 26 Follow-up after 52 | RE: 1–4 sets of 6–12 repetitions (leg press, leg extension, leg curl, chest press, seated row, lat pulldown and biceps curl) AE: 25–40 min (various modalities) IT (hopping, leaping and drop jumping) | 3 ×/week supervised exercise, 1 h/session (3 × IT, 1–2 × RE, 1–2 × AE) 10 min warm-up RE varying between 6RM and 12RM or AE at 60–85% of eHRmax IT mostly sets of 10 repetitions 5 min cool-down Additional home-based AE and IT 2 ×/week | Primary outcome: bone mineral density: ↓ BMD for both groups over 52 weeks Tendency for lesser decrease for IEI after 26 weeks, DEI after 52 weeks Secondary outcomes: ↑ Fat mass (greater increase in DEI at 26 weeks) ↔ Lean tissue mass (IEI), ↓ in DEI at 26 weeks, ↑ at 52 weeks ↑ Self-reported physical activity (GodinQ) in IEI, (↑) in DEI ↑ Markers of bone turnover in IEI and DEI Substantially higher drop-out rate in DEI Some patients ceased ADT before the end of the study |
Galvao et al. [51] | EI n = 28 Cont (usual care) n = 29 | EI 69.7 ± 7.6 Cont 70.4 ± 9.3 | Men with prostate cancer and bone metastatic disease | 12 | RE 3 sets of 10–12 repetitions (exercises targeting major muscle groups adapted according to site of metastatic disease) AE 20–30 min (various modalities) FLEX 2–4 repetitions of 30–60 sec (static stretching for all major joints) | 3 ×/week supervised exercise, 1 h/session 10 min warm-up RE 10RM–12RM AE at 60–85% of eHRmax FLEX 5 min cool-down | Primary outcome: SF-36 physical function subscale: ↑ Physical functioning (EI) Secondary outcomes: ↑ Muscle strength (EI) ↔ Objective physical functioning (TUG, 6mWT, 400mWT) ↔ Body composition ↔ Fatigue (FACIT-F) No adverse effects of EI Patients with metastatic disease Missing values for several tests due to feasibility Complete case analysis |
Ndjavera et al. [48] | EI n = 24 Cont (usual care) n = 26 | EI 71.4 ± 5.4 Cont 72.5 ± 4.2 | Men with prostate cancer beginning ADT | 13, follow-up at 26 | RE 2–4 sets of 10 repetitions (dumbbell squat, modified press-up, dumbbell bent-over row, dumbbell biceps curl, short arc quad, wall squat) AE 6 × 5 min with 2.5 min active recovery (aerobic interval training on a cycle ergometer) | 2 ×/week supervised exercise, 1 h/session 5 min warm-up RE at 11–15 RPE (Borg 6–20) AE at 11–15 RPE (Borg 6–20) Advice to perform additional home-based AE and RE 3 ×/week | Primary outcome: Body fat mass: (↓) Body fat mass (EI) at 13 and 26 weeks Secondary outcomes: ↑ VO2max at 13 weeks, ↔ at 26 weeks (EI) ↓ Fatigue (FACIT-F) at 13 weeks, ↔ at 26 weeks (EI) ↔ Self-reported physical activity (GodinQ) at 13 weeks, ↑ at 26 weeks (EI) ↔ HRQOL (FACT-P) at 13 weeks, ↑ at 26 weeks (EI) ↔ Body composition ↔ Handgrip strength ↔ Metabolic profile |
Gazova et al. [47] | EI n = 15 Cont (usual care) n = 8 | EI 69.2 ± 5.8 Cont 70.7 ± 7.5 | Men with localized prostate cancer on ADT | 16 | RE 2–3 sets of 10–15 repetitions (five exercises) | 3 ×/week supervised exercise RE week 1–4 30% of 10–15RM, week 5–12 90–100% of 10–12RM, week 13–16 90–100% of 10–15RM | Primary outcomes: ↑Muscle strength (EI) ↔ Body weight ↔ BMI ↔ BMD ↑ 6MWT (EI) ↔ Stair climbing ↑ Metabolic profile (EI) Secondary outcome: ↑ Myogenic microRNA (EI) Small sample size High risk of bias Within-group comparison |
Additional articles
Additional article | Expansion | Key findings/comments |
---|---|---|
Taaffe et al. [53] Additional article of Newton et al. [49] | Additional results | ↓ Fatigue (EORTC QLQ-C30 fatigue subscale, IRE at 26 and 52 weeks, RAE at 52 weeks, DAE at 52 weeks) ↑ Vitality (SF-36, IRE, RAE and DAE at 52 weeks) ↑ Cardiorespiratory fitness (400mWT, IRE and RAE at 52 weeks, no change in DAE) ↑ Muscle strength (sum of chest press and leg press, IRE at 26 < 52 weeks, RAE at 26 and 52 weeks, DAE at 52 weeks) No group × time interaction |
Wall et al. [52] Additional article of Newton et al. [49] | Additional results RAE vs. DAE in the first 26 weeks | ↑ Cardiorespiratory capacity (VO2max, RAE) ↑ Fat oxidation (RAE) ↔ RMR ↔ BP ↔ Arterial stiffness ↔ Metabolic profile ↔ PSA and testosterone ↑ Lean tissue mass (RAE) ↓ Fat mass (RAE) Between-group comparison |
Fairman et al. [55] Additional article of Galvao et al. [51] | Additional results Training dose, adherence and tolerance | Actual training volume = 77.4% of prescribed Training interrupted (≥3 consecutive sessions missed) in half of patients Training missed (≤2 consecutive sessions missed) in approximately 90% of patients. Training dose modified in approximately 85% of patients |
Edmunds et al. [56] Additional article of Galvao et al. [21] | Cost-effectiveness analysis | 26 weeks of supervised exercise for prostate cancer survivors probably not cost-effective |
Newton et al. [54] Additional article of Taaffe et al. [50] | Additional results | ↑ Muscle strength – In IEI at 26 weeks – In DEI at 52 weeks – No difference at 52 weeks ↑ Physical function – 6mWT (only in IEI at 26 weeks) – 400mWT (IEI at 26 weeks, DEI at 52 weeks) – Stair climbing (IEI at 26 weeks, DEI at 52 weeks) – Repeated chair rise (IEI at 26 weeks, DEI at 52 weeks) – Significant difference only for 6mWT at 52 weeks Between-group comparison |
Sexual health
Study | Sexual health-related outcome | Results |
---|---|---|
Lyons et al. [45] Additional article of Winters-Stone et al. [30] | Levels of physical intimacy | Engagement in affectionate and sexual behavior – Engagement in affectionate behavior: ↑ in spouses, ↔ in patients – Engagement in sexual behavior: ↔ in patients and spouses |
Cormie et al. [18] | Disease-specific health-related quality of life (EORTC QLQ-PR25) | ↑ Physical, mental and sexual function |
Cormie et al. [34] Additional article of Galvao et al. [20] | Disease-specific health-related quality of life (EORTC QLQ-PR25) | Comparison EI vs. Cont postintervention: ↑ Sexual activity in EI ↑ Major interest in sex in EI (↑) Any level of interest in sex in EI Significant associations: – Change in sexual activity postintervention with change in perceived general health and role-emotional |