Effects of strength training on body composition, physical functioning, and quality of life in prostate cancer patients during androgen deprivation therapy

Abstract

Background. Androgen deprivation therapy (ADT) increases survival rates in prostate cancer (PCa) patients with locally advanced disease, but is associated with side effects that may impair daily function. Strength training may counteract several side effects of ADT, such as changes in body composition and physical functioning, which in turn may affect health-related quality of life (HRQOL). However, additional randomised controlled trials are needed to expand this knowledge.

Material and methods. Fifty-eight PCa patients on ADT were randomised to either 16 weeks of high-load strength training (n = 28) or usual care (n = 30). The primary outcome was change in total lean body mass (LBM) assessed by dual x-ray absorptiometry (DXA). Secondary outcomes were changes in regional LBM, fat mass, and areal bone mineral density (aBMD) measured by DXA; physical functioning assessed by 1-repetition maximum (1RM) tests, sit-to-stand test, stair climbing test and Shuttle walk test; and HRQOL as measured by the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30.

Results and Conclusion. No statistically significant effect of high-load strength training was demonstrated on total LBM (p = 0.16), but significant effects were found on LBM in the lower and upper extremities (0.49 kg, p < 0.01 and 0.15 kg, p < 0.05, respectively). Compared to usual care, high-load strength training showed no effect on fat mass, aBMD or HRQOL, but beneficial effects were observed in all 1RM tests, sit-to-stand test and stair climbing tests. Adherence to the training program was 88% for lower body exercises and 84% for upper body exercises. In summary, high-load strength training improved LBM in extremities and physical functioning, but had no effect on fat mass, aBMD, or HRQOL in PCa patients on ADT.

Acknowledgements

This work was supported by the Norwegian Foundation of Health and Rehabilitation and the Norwegian Cancer Society (HF-57004/001) and co-funded by the Regional Health Authority in Southern Norway. Additional funding was also given by Eckbo's legacy, The Radium Hospital's legacy and Trivselsanlegget's legacy. Thanks to all patients for participating and to Melanie-Birte Schulz, Stine Solli, Siri Kjellaas, Jon Reidar Iversen, Nils K. Raabe, Kjell Magne Russnes and Gunnar Tafjord for their help identifying and including patients. Thanks also to Karol Axcrona for useful comments regarding the design and to Arne Høiseth for evaluating the DXA scans. The authors also thank the Department for Clinical Research Support, Oslo University Hospital, for their assistance with tasks related to the data management of this study.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.