Date of Award
2023
Document Type
Thesis
Publisher
Edith Cowan University
Degree Name
Doctor of Philosophy
School
School of Medical and Health Sciences
First Supervisor
Daniel A. Galvao
Second Supervisor
Robert U. Newton
Third Supervisor
Dennis R. Taaffe
Fourth Supervisor
Laurien M. Buffart
Abstract
Information on specific prognostic factors such as the association of body composition with survival and tailored strategies considering demographic and clinical factors as well as the influence of exercise tolerance and compliance are required to establish targeted exercise prescription in men with prostate cancer. As a result, the purpose of this doctoral research is to: (i) investigate the role of body composition on overall survival in men with prostate cancer; (ii) determine which type of exercise/physical activity and/or dietary intervention is most effective for improving body composition outcomes in this population; (iii) examine the demographic and clinical characteristics of resistance exercise response in cardiometabolic outcomes including body fat, fat mass and trunk fat mass, hip and waist circumference, cardiovascular outcomes, lipid profile, glucose metabolism and inflammation; (iv) examine the demographic and clinical moderators of resistance exercise response in sarcopenia-related outcomes including lean mass and appendicular lean mass, physical function and muscle strength; (v) examine the exercise prescription moderators of resistance exercise response in body composition, physical function and muscle strength; (vi) examine the exercise prescription moderators of resistance exercise response in fatigue, quality of life, depression and anxiety; and (vii) examine whether resistance exercise compliance characteristics influence changes in body composition, physical function and muscle strength in men with localised or locally advanced prostate cancer. A series of studies including pairwise, network and individual patient data meta-analyses as well as secondary analysis of a previous exercise trial were undertaken to examine the research questions encompassed in the present thesis. Our main findings were that (i) high muscle mass is associated with ~50% survival advantage in menwith prostate cancer; (ii) resistance-based exercise programs alone or combined with a general
healthy diet are the most effective interventions for reducing fat mass (-0.5 kg, 95% CI: -0.9 to -0.1 kg) and increasing lean mass (0.6 kg, 95% CI: 0.1 to 1.0 kg) in men with prostate cancer; (iii) specific subgroups of patients such as those with higher fat mass levels (-1.0 kg, 95% CI: -1.8 to -0.1 kg) responded more favourably in fat mass, while those with lower baseline levels of 400-m walk (-19.4 sec, 95% CI: -36.6 to -2.3 sec) and 6-m backward walk tests (-3.0 sec, 95% CI: -5.7 to -0.3 sec) responded more favourably in these outcomes to resistance exercise programs than others; and (iv) a lower volume of resistance exercise (i.e., twice a week, 1 set of 12 repetitions for 6 resistance exercises) undertaken at a moderate-to-high intensity was sufficient to elicit significant improvements in physical function and patient-reported outcomes, while a higher dosage (i.e., twice a week, 3 sets of 12 repetitions for 6 resistance exercises) was necessary to achieve better results for body composition (P < 0.05). These findings are important for improving recommendations of resistance exercise during and following prostate cancer treatment and to develop more targeted and tailored resistance-based programs for men with prostate cancer during and following primary treatment.
Recommended Citation
Lopez Da Cruz, P. (2023). Exploring demographic, clinical and exercise prescription moderators of resistance exercise effects on objectively measured and patient-reported outcomes in men with prostate cancer. Edith Cowan University. Retrieved from https://ro.ecu.edu.au/theses/2632