Daniel A. Galvao, Edith Cowan UniversityFollow
Dennis R. Taaffe, Edith Cowan UniversityFollow
Nigel Spry, Edith Cowan UniversityFollow
David Joseph, Edith Cowan UniversityFollow
Suzanne K. Chambers, Edith Cowan UniversityFollow
Raphael Chee, Edith Cowan UniversityFollow
Carolyn J. Peddle-Mcintyre, Edith Cowan UniversityFollow
Nicolas H. Hart, Edith Cowan UniversityFollow
Freerk T. Baumann
Robert U. Newton
Lippincott Williams and Wilkins
Exercise Medicine Research Institute
The presence of bone metastases has excluded participation of cancer patients in exercise interventions and is a relative contraindication to supervised exercise in the community setting due to concerns of fragility fracture. We examined the efficacy and safety of a modular multi-modal exercise program in prostate cancer patients with bone metastases.Between 2012 and 2015, 57 prostate cancer patients (70.0 ± 8.4 years; BMI 28.7 ± 4.0 kg/m) with bone metastases (pelvis 75.4%, femur 40.4%, rib/thoracic spine 66.7%, lumbar spine 43.9%, humerus 24.6%, other sites 70.2%) were randomised to multi-modal supervised aerobic, resistance and flexibility exercises undertaken thrice weekly (EX, n = 28) or usual care (CON, n = 29) for 3 months. Physical function subscale of the SF-36 was the primary endpoint as an indicator of patient-rated physical functioning. Secondary endpoints included objective measures of physical function, lower body muscle strength, body composition and fatigue. Safety was assessed by recording the incidence and severity of any adverse events, skeletal complications, and bone pain throughout the intervention.There was a significant difference between groups for self-reported physical functioning (3.2 points, 95% CI 0.4-6.0 points; p = 0.028) and lower body muscle strength (6.6 kg, 95% CI 0.6-12.7; p = 0.033) at 3 months favouring EX. However, there was no difference between groups for lean mass (p = 0.584), fat mass (p = 0.598), or fatigue (p = 0.964). There were no exercise-related adverse events or skeletal fractures and no differences in bone pain between EX and CON (p = 0.507). Multi-modal modular exercise in prostate cancer patients with bone metastases led to self-reported improvements in physical function and objectively measured lower body muscle strength with no skeletal complications or increased bone pain.
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