Skeletal response to resistance and impact training in prostate cancer survivors.
BACKGROUND
Androgen deprivation therapy (ADT) is associated with significant bone loss and an increase in fracture risk among prostate cancer survivors (PCS). We investigated whether impact + resistance training could stop ADT-related declines in bone mineral density (BMD) among PCS on ADT.


METHODS
We randomized 51 PCS (mean age, 70.2 yr) currently prescribed ADT to participate in 1 yr of impact + resistance training (Prevent Osteoporosis with Impact + Resistance (POWIR)) or in an exercise placebo program of stretching exercise (FLEX). Outcomes were proximal femur (total hip, femoral neck, and greater trochanter) and spine (L1-L4) BMD (g·cm) and bone turnover markers (serum osteocalcin (ng·mL) and urinary deoxypyrodinoline cross-links (nmol·mmol Cr)).


RESULTS
Retention in the 1-yr study was 84% and median attendance to supervised classes was 84% in POWIR and 74% in FLEX. No study-related injuries were reported. There were no significant differences between groups for average L1-L4 BMD or for BMD at any hip site. When examining individual vertebrae, POWIR has a significant effect on preservation of BMD (-0.4%) at the L4 vertebrae compared with losses (-3.1%) in FLEX (P = 0.03).


CONCLUSIONS
Impact + resistance training was a safe and acceptable form of exercise for older PCS on ADT. Among our limited sample, POWIR did not appear to have a clinically meaningful effect on hip or spine BMD, but some evidence of skeletal adaptation to resistance + impact training in an androgen-deprived state was apparent. Future studies need to be conducted on a larger sample of patients and should consider modifications to POWIR that could further enhance loading across the spine and at the hip to preserve BMD at these clinically relevant sites.
1School of Nursing, Oregon Health and Science University, Portland, OR; 2School of Medicine, Oregon Health and Science University, Portland, OR; and 3Knight Cancer Institute, Oregon Health and Science University, Portland, OR; 4Department of Exercise and Sport Science, School of Biologic and Population Health, Oregon State University, Corvallis, OR.
Kerri M
KM
Winters-Stone
Jessica C
JC
Dobek
Jill A
JA
Bennett
Gianni F
GF
Maddalozzo
Christopher W
CW
Ryan
Tomasz M
TM
Beer
D000726:Androgen Antagonists / Q000627:therapeutic use*; D015519:Bone Density; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000517:prevention & control*; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D055070:Resistance Training; D016037:Single-Blind Method; D017741:Survivors
D000726:Androgen Antagonists