Taaffe, Dennis R.;
Galvão, Daniel A.;
Spry, Nigel;
Joseph, David;
Chambers, Suzanne K.;
Gardiner, Robert A.;
Hayne, Dickon;
Cormie, Prue;
Shum, David H.K.;
Newton, Robert U.
Immediate versus delayed exercise in men initiating androgen deprivation: effects on bone density and soft tissue composition
Sie können Bookmarks mittels Listen verwalten, loggen Sie sich dafür bitte in Ihr SLUB Benutzerkonto ein.
Medientyp:
E-Artikel
Titel:
Immediate versus delayed exercise in men initiating androgen deprivation: effects on bone density and soft tissue composition
Beteiligte:
Taaffe, Dennis R.;
Galvão, Daniel A.;
Spry, Nigel;
Joseph, David;
Chambers, Suzanne K.;
Gardiner, Robert A.;
Hayne, Dickon;
Cormie, Prue;
Shum, David H.K.;
Newton, Robert U.
Beschreibung:
<jats:sec><jats:title>Objectives</jats:title><jats:p>To examine whether it is more efficacious to commence exercise medicine in men with prostate cancer at the onset of <jats:styled-content style="fixed-case">androgen‐deprivation therapy (ADT)</jats:styled-content> rather than later on during treatment to preserve bone and soft‐tissue composition, as <jats:styled-content style="fixed-case">ADT</jats:styled-content> results in adverse effects including: reduced bone mineral density (<jats:styled-content style="fixed-case">BMD</jats:styled-content>), loss of muscle mass, and increased fat mass (FM).</jats:p></jats:sec><jats:sec><jats:title>Patients and methods</jats:title><jats:p>In all, 104 patients with prostate cancer, aged 48–84 years initiating <jats:styled-content style="fixed-case">ADT,</jats:styled-content> were randomised to immediate exercise (<jats:styled-content style="fixed-case">IMEX</jats:styled-content>,<jats:italic> n</jats:italic> = 54) or delayed exercise (<jats:styled-content style="fixed-case">DEL</jats:styled-content>,<jats:italic> n</jats:italic> = 50) conditions. The former consisted of 6 months of supervised resistance/aerobic/impact exercise and the latter comprised 6 months of usual care followed by 6 months of the identical exercise programme. Regional and whole body <jats:styled-content style="fixed-case">BMD</jats:styled-content>, lean mass (LM), whole body FM and trunk FM, and appendicular skeletal muscle (<jats:styled-content style="fixed-case">ASM</jats:styled-content>) were assessed by dual X‐ray absorptiometry, and muscle density by peripheral quantitative computed tomography at baseline, and at 6 and 12 months.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>There was a significant time effect (<jats:italic>P</jats:italic> < 0.001) for whole body, spine and hip <jats:styled-content style="fixed-case">BMD</jats:styled-content> with a progressive loss in the <jats:styled-content style="fixed-case">IMEX</jats:styled-content> and <jats:styled-content style="fixed-case">DEL groups</jats:styled-content>, although lumbar spine <jats:styled-content style="fixed-case">BMD</jats:styled-content> was largely preserved in the <jats:styled-content style="fixed-case">IMEX</jats:styled-content> group at 6 months compared with the <jats:styled-content style="fixed-case">DEL</jats:styled-content> group (−0.4% vs −1.6%). LM, <jats:styled-content style="fixed-case">ASM</jats:styled-content>, and muscle density were preserved in the <jats:styled-content style="fixed-case">IMEX</jats:styled-content> group at 6 months, declined in the <jats:styled-content style="fixed-case">DEL</jats:styled-content> group at 6 months (−1.4% to −2.5%) and then recovered at 12 months after training. FM and trunk FM increased (<jats:italic>P</jats:italic> < 0.001) over the 12‐month period in the <jats:styled-content style="fixed-case">IMEX</jats:styled-content> (7.8% and 4.5%, respectively) and <jats:styled-content style="fixed-case">DEL</jats:styled-content> groups (6.5% and 4.3%, respectively).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Commencing exercise at the onset of <jats:styled-content style="fixed-case">ADT</jats:styled-content> preserves lumbar spine <jats:styled-content style="fixed-case">BMD</jats:styled-content>, muscle mass, and muscle density. To avoid treatment‐related adverse musculoskeletal effects, exercise medicine should be prescribed and commenced at the onset of <jats:styled-content style="fixed-case">ADT</jats:styled-content>.</jats:p></jats:sec>