Effects of a 15-Month Supervised Exercise Program on Physical and Psychological Outcomes in Prostate Cancer Patients Following Prostatectomy: The ProRehab Study.
OBJECTIVE
Despite advanced medical treatment options, many prostate cancer patients are still confronted with unfavorable physical and psychological burdens. Physical exercise has proven to be beneficial for prostate cancer patients, yet specific exercise offers are rare. The ProRehab Study aimed to evaluate the exercise program offered in rehabilitative prostate cancer sports groups in Germany and determine whether it is beneficial for patients following prostatectomy.


METHODS
Eighty-five prostate cancer patients were recruited for a multicenter, 2-armed, nonrandomized controlled trial 6 to 12 weeks after prostatectomy. The intervention group (n = 56) took part in a 15-month supervised multimodal exercise program. Exercise sessions took place once a week for 60 minutes at a moderate intensity (3.84-4.84 MET-hour). The control group (n = 29) received no intervention. Outcomes included aerobic fitness, activity levels, quality of life, disease- and treatment-related adverse effects, such as urinary incontinence and erectile dysfunction, and relapse-relevant blood values. Intention-to-treat analysis was performed.


RESULTS
A significant between-group difference was observed in the urinary symptom score (P = .027). Physical fitness, urinary incontinence, physical, role, emotional, and social functioning, as well as further disease- and treatment-related side effects (dyspnea, urinary, and bowel symptoms) significantly improved within the intervention group. Erectile dysfunction and physical activity levels improved similarly in both groups.


CONCLUSIONS
The presented data hint at the potential of rehabilitative sports groups for prostate cancer patients. However, according to the current state of the art, exercise intensity and volume may need to be increased to enhance the effects. A number of shorter studies (8-24 weeks) have proven significant between-group differences in quality of life, incontinence, and fitness outcomes when patients exercised 2 to 3 times per week. This is the first exercise intervention study with prostate cancer patients that was conducted over 15 months. Further studies are necessary to investigate whether prostate cancer patients recover sooner when receiving a supervised exercise program.
German Sport University Cologne, Cologne, Germany e.zopf@dshs-koeln.de.
Eva M
EM
Zopf
German Sport University Cologne, Cologne, Germany.
Wilhelm
W
Bloch
Marien Hospital Bergisch Gladbach, Bergisch Gladbach, Germany.
Stefan
S
Machtens
Clinical Centre Leverkusen, Leverkusen, Germany.
Jürgen
J
Zumbé
University Hospital Essen, Essen, Germany.
Herbert
H
Rübben
Heilig-Geist-Hospital Cologne-Longerich, Cologne, Germany.
Stefan
S
Marschner
Marien Hospital Bergisch Gladbach, Bergisch Gladbach, Germany.
Christian
C
Kleinhorst
Fresenius University of Applied Sciences, Cologne, Germany.
Birgit
B
Schulte-Frei
University of Cologne, Cologne, Germany.
Lena
L
Herich
University of Cologne, Cologne, Germany.
Moritz
M
Felsch
German Sport University Cologne, Cologne, Germany.
Hans-Georg
HG
Predel
Heilig-Geist-Hospital Cologne-Longerich, Cologne, Germany.
Moritz
M
Braun
German Sport University Cologne, Cologne, Germany.
Freerk T
FT
Baumann
D000368:Aged; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology; D005081:Exercise Therapy / Q000379:methods*; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000523:psychology / Q000534:rehabilitation* / Q000628:therapy; D011788:Quality of Life; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology
cancer rehabilitation; exercise; physical activity; prostate cancer; prostatectomy; rehabilitative sports groups