title: Novel physical activity interventions for older patients with prostate cancer on hormone therapy: A pilot randomized study.
abstract: BACKGROUND
  Androgen deprivation therapy (ADT) can decrease the physical performance (PP) of older men with prostate cancer (PC).
  
  
  METHODS
  We conducted a three-arm randomized pilot study (n=19) comparing a home-based walking and resistance intervention (EXCAP) and a technology-mediated walking and resistance intervention using Wii-Fit to a usual-care arm in men ≥70 years with PC receiving ADT. The intervention lasted for 6 weeks, with follow-up at 12 weeks. The primary pre-specified outcome was change in Short Physical Performance Battery (SPPB) score. Mixed effects regression models were used to assess change in outcomes over time.
  
  
  RESULTS
  Mean participant age was 70 years (range: 67-93). Eight patients were randomized to the Wii-Fit arm, 6 to the EXCAP arm, and 5 to the usual-care arm. SPPB scores remained nearly constant in the usual-care arm (β=-0.12; p=0.79), while individuals in the EXCAP arm had on average a 1.2 point increase at each follow-up (β=1.20; 95% CI: 0.36, 2.06). The Wii-fit arm had a non-significant increase in SPPB score over time relative to usual-care (β=0.32; 95% CI -0.43, 1.06; p=0.46). Individuals in the EXCAP arm had an increase in steps per day over time compared to the usual-care arm (p-value=0.006); the EXCAP arm had an increase of 2720 steps (95% CI: 1313, 4128) while the usual-care arm had an increase of 97 steps (95% CI: -1140, 1333). Participants in the Wii-Fit arm had an increase of 1020 steps (95% CI: -474, 1238, p=0.710). Other outcomes (i.e., handgrip strength, lean muscle mass, and chest press repetitions) were not statistically significant.
  
  
  CONCLUSIONS
  A home-based aerobic and resistance exercise program, EXCAP, shows promise for improving PP in older men with PC on ADT.
authors.affiliation: Department of Medicine, Section of Geriatrics & Palliative Medicine, and Hematology/Oncology, University of Chicago, Chicago, IL, USA. Electronic address: salehasajid@gmail.com.
authors.forename: Saleha
authors.initials: S
authors.lastname: Sajid
authors.affiliation: Department of Medicine, Section of Geriatrics & Palliative Medicine, and Hematology/Oncology, University of Chicago, Chicago, IL, USA. Electronic address: wdale@medicine.bsd.uchicago.edu.
authors.forename: William
authors.initials: W
authors.lastname: Dale
authors.affiliation: Department of Medicine, James Wilmot Cancer Institute, University of Rochester, Rochester, NY, USA. Electronic address: Karen_mustian@urmc.rochester.edu.
authors.forename: Karen
authors.initials: K
authors.lastname: Mustian
authors.affiliation: Department of Medicine, Section of Geriatrics & Palliative Medicine, and Hematology/Oncology, University of Chicago, Chicago, IL, USA. Electronic address: akotwal@uchicago.edu.
authors.forename: Ashwin
authors.initials: A
authors.lastname: Kotwal
authors.affiliation: Department of Medicine, James Wilmot Cancer Institute, University of Rochester, Rochester, NY, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Heckler
authors.affiliation: Department of Medicine, James Wilmot Cancer Institute, University of Rochester, Rochester, NY, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Porto
authors.affiliation: Department of Medicine, James Wilmot Cancer Institute, University of Rochester, Rochester, NY, USA. Electronic address: chunkit_fung@urmc.rochester.edu.
authors.forename: Chunkit
authors.initials: C
authors.lastname: Fung
authors.affiliation: Department of Medicine, James Wilmot Cancer Institute, University of Rochester, Rochester, NY, USA. Electronic address: Supriya_mohile@urmc.rochester.edu.
authors.forename: Supriya G
authors.initials: SG
authors.lastname: Mohile
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D018737:Hand Strength; D006801:Humans; D016014:Linear Models; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D010865:Pilot Projects; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000503:physiopathology* / Q000534:rehabilitation; D016138:Walking / Q000502:physiology*
chemical_list: D000726:Androgen Antagonists
keywords: Androgen deprivation therapy; Elderly; Home-based exercise interventions; Older adults; Prostate cancer; Wii-Fit