Effects of exercise on disablement process model outcomes in prostate cancer patients undergoing androgen deprivation therapy

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Effects of exercise on disablement process model outcomes in prostate cancer patients undergoing androgen deprivation therapy
Background Androgen-deprivation therapy (ADT) results in adverse physiologic, metabolic, and functional side effects that may accelerate functional limitations in patients with prostate cancer (PC). Although exercise improves muscular strength and functional performance, the extent to which exercise yields similar improvements in other disablement process outcomes in men on ADT has yet to be systematically evaluated.

Objective To explore whether exercise results in comparable improvements in physiologic and structural body system impairment, functional limitation (relating to basic physical or mental actions), and physical disability domain outcomes identified in the Disablement Process Model (DPM) in PC patients who are receiving ADT.

Methods Data from studies of exercise interventions in men on ADT were extracted on impairment, functional limitation, and physical disability domain outcomes. The average of weighted, bias-corrected effect sizes were calculated for each outcome and compared across domains. A total of 9 studies (6 randomized controlled trials, 3 uncontrolled trials) conducted with 684 PC patients met the inclusion criteria.

Results Exercise yielded heterogeneous effect-size improvements in physical impairments, ranging from large improvements in muscular strength (d = .74; 95% CI, .14-1.47) and endurance (d = 2.64; 95% CI, 1.08-2.84), to small improvements in body composition measures (d = .12; 95% CI, -.52-.68).

Conclusions Whereas exercise resulted in meaningful effect-size improvements in functional limitation domain outcomes (d = .39; 95% CI, -.42-1.01), findings from the 4 studies that assessed a physical disability, domain outcomes revealed only small improvements (d = .10; 95% CI, -.44-.43) in these outcomes. Collectively, exercise consistently results in meaningful improvements in physical impairments and functional limitations in basic physical tasks. However, to date, few studies have evaluated the effects of exercise on physical disability domain outcomes, and the results suggest that the effects of exercise on physical disability measures are of a smaller magnitude relative to those observed for impairment and functional limitation domain outcomes.



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The Journal of Community and Supportive Oncology - 12(8)
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278-292
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prostate cancer, androgen-deprivation therapy, ADT, Disablement Process Model, DPM
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Background Androgen-deprivation therapy (ADT) results in adverse physiologic, metabolic, and functional side effects that may accelerate functional limitations in patients with prostate cancer (PC). Although exercise improves muscular strength and functional performance, the extent to which exercise yields similar improvements in other disablement process outcomes in men on ADT has yet to be systematically evaluated.

Objective To explore whether exercise results in comparable improvements in physiologic and structural body system impairment, functional limitation (relating to basic physical or mental actions), and physical disability domain outcomes identified in the Disablement Process Model (DPM) in PC patients who are receiving ADT.

Methods Data from studies of exercise interventions in men on ADT were extracted on impairment, functional limitation, and physical disability domain outcomes. The average of weighted, bias-corrected effect sizes were calculated for each outcome and compared across domains. A total of 9 studies (6 randomized controlled trials, 3 uncontrolled trials) conducted with 684 PC patients met the inclusion criteria.

Results Exercise yielded heterogeneous effect-size improvements in physical impairments, ranging from large improvements in muscular strength (d = .74; 95% CI, .14-1.47) and endurance (d = 2.64; 95% CI, 1.08-2.84), to small improvements in body composition measures (d = .12; 95% CI, -.52-.68).

Conclusions Whereas exercise resulted in meaningful effect-size improvements in functional limitation domain outcomes (d = .39; 95% CI, -.42-1.01), findings from the 4 studies that assessed a physical disability, domain outcomes revealed only small improvements (d = .10; 95% CI, -.44-.43) in these outcomes. Collectively, exercise consistently results in meaningful improvements in physical impairments and functional limitations in basic physical tasks. However, to date, few studies have evaluated the effects of exercise on physical disability domain outcomes, and the results suggest that the effects of exercise on physical disability measures are of a smaller magnitude relative to those observed for impairment and functional limitation domain outcomes.



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Background Androgen-deprivation therapy (ADT) results in adverse physiologic, metabolic, and functional side effects that may accelerate functional limitations in patients with prostate cancer (PC). Although exercise improves muscular strength and functional performance, the extent to which exercise yields similar improvements in other disablement process outcomes in men on ADT has yet to be systematically evaluated.

Objective To explore whether exercise results in comparable improvements in physiologic and structural body system impairment, functional limitation (relating to basic physical or mental actions), and physical disability domain outcomes identified in the Disablement Process Model (DPM) in PC patients who are receiving ADT.

Methods Data from studies of exercise interventions in men on ADT were extracted on impairment, functional limitation, and physical disability domain outcomes. The average of weighted, bias-corrected effect sizes were calculated for each outcome and compared across domains. A total of 9 studies (6 randomized controlled trials, 3 uncontrolled trials) conducted with 684 PC patients met the inclusion criteria.

Results Exercise yielded heterogeneous effect-size improvements in physical impairments, ranging from large improvements in muscular strength (d = .74; 95% CI, .14-1.47) and endurance (d = 2.64; 95% CI, 1.08-2.84), to small improvements in body composition measures (d = .12; 95% CI, -.52-.68).

Conclusions Whereas exercise resulted in meaningful effect-size improvements in functional limitation domain outcomes (d = .39; 95% CI, -.42-1.01), findings from the 4 studies that assessed a physical disability, domain outcomes revealed only small improvements (d = .10; 95% CI, -.44-.43) in these outcomes. Collectively, exercise consistently results in meaningful improvements in physical impairments and functional limitations in basic physical tasks. However, to date, few studies have evaluated the effects of exercise on physical disability domain outcomes, and the results suggest that the effects of exercise on physical disability measures are of a smaller magnitude relative to those observed for impairment and functional limitation domain outcomes.



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The Journal of Community and Supportive Oncology - 12(8)
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The Journal of Community and Supportive Oncology - 12(8)
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278-292
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Effects of exercise on disablement process model outcomes in prostate cancer patients undergoing androgen deprivation therapy
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Effects of exercise on disablement process model outcomes in prostate cancer patients undergoing androgen deprivation therapy
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prostate cancer, androgen-deprivation therapy, ADT, Disablement Process Model, DPM
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prostate cancer, androgen-deprivation therapy, ADT, Disablement Process Model, DPM
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Resistance exercise interventions during and following cancer treatment: a systematic review

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Resistance exercise interventions during and following cancer treatment: a systematic review

Findings from prior systematic reviews suggest that exercise results in meaningful improvements in many clinically relevant physiologic and quality of life (QoL) outcomes during and following cancer treatment. However, the majority of exercise-cancer studies have focused upon the benefits of aerobic exercise (AE) and knowledge of the efficacy of resistance exercise (RE) alone as a supportive care intervention for cancer patients and survivors remains limited. Consequently, the purpose of this review was to provide the first systematic evaluation of the effects of RE alone upon clinically relevant physiologic and QoL outcomes during and following cancer treatment. Literature searches were conducted to identify studies examining RE interventions in cancer patients and survivors. Data were extracted on physiologic (fitness, physical function, and body composition) and QoL (fatigue, psychological well-being, and cancer-specific and global QoL outcomes. Cohen’s d effect sizes were calculated for each outcome. A total of 15 studies (6 in samples undergoing active cancer treatment and 9 in samples having completed cancer treatment) involving 1,077 participants met the inclusion criteria. Findings revealed that, on average, RE resulted in large effectsize improvements in muscular strength (d 0.86), moderate effect-size improvements in physical function (d 0.66), and small effect-size improvements in body composition (d 0.28) and QoL (d 0.25) outcomes. The effect sizes observed following RE are comparable in magnitude to the effects of exercise interventions reported in prior comprehensive reviews of the exercise cancer literature which primarily focused upon AE. Additionally, the methodologic quality of the studies was generally strong. Taken collectively, results of this systematic review suggest that RE is a promising supportive care intervention that results in meaningful improvements in clinically relevant physiologic and QoL outcomes during and following cancer treatment.

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Findings from prior systematic reviews suggest that exercise results in meaningful improvements in many clinically relevant physiologic and quality of life (QoL) outcomes during and following cancer treatment. However, the majority of exercise-cancer studies have focused upon the benefits of aerobic exercise (AE) and knowledge of the efficacy of resistance exercise (RE) alone as a supportive care intervention for cancer patients and survivors remains limited. Consequently, the purpose of this review was to provide the first systematic evaluation of the effects of RE alone upon clinically relevant physiologic and QoL outcomes during and following cancer treatment. Literature searches were conducted to identify studies examining RE interventions in cancer patients and survivors. Data were extracted on physiologic (fitness, physical function, and body composition) and QoL (fatigue, psychological well-being, and cancer-specific and global QoL outcomes. Cohen’s d effect sizes were calculated for each outcome. A total of 15 studies (6 in samples undergoing active cancer treatment and 9 in samples having completed cancer treatment) involving 1,077 participants met the inclusion criteria. Findings revealed that, on average, RE resulted in large effectsize improvements in muscular strength (d 0.86), moderate effect-size improvements in physical function (d 0.66), and small effect-size improvements in body composition (d 0.28) and QoL (d 0.25) outcomes. The effect sizes observed following RE are comparable in magnitude to the effects of exercise interventions reported in prior comprehensive reviews of the exercise cancer literature which primarily focused upon AE. Additionally, the methodologic quality of the studies was generally strong. Taken collectively, results of this systematic review suggest that RE is a promising supportive care intervention that results in meaningful improvements in clinically relevant physiologic and QoL outcomes during and following cancer treatment.

Click on the PDF icon at the top of this introduction to read the full article.

Findings from prior systematic reviews suggest that exercise results in meaningful improvements in many clinically relevant physiologic and quality of life (QoL) outcomes during and following cancer treatment. However, the majority of exercise-cancer studies have focused upon the benefits of aerobic exercise (AE) and knowledge of the efficacy of resistance exercise (RE) alone as a supportive care intervention for cancer patients and survivors remains limited. Consequently, the purpose of this review was to provide the first systematic evaluation of the effects of RE alone upon clinically relevant physiologic and QoL outcomes during and following cancer treatment. Literature searches were conducted to identify studies examining RE interventions in cancer patients and survivors. Data were extracted on physiologic (fitness, physical function, and body composition) and QoL (fatigue, psychological well-being, and cancer-specific and global QoL outcomes. Cohen’s d effect sizes were calculated for each outcome. A total of 15 studies (6 in samples undergoing active cancer treatment and 9 in samples having completed cancer treatment) involving 1,077 participants met the inclusion criteria. Findings revealed that, on average, RE resulted in large effectsize improvements in muscular strength (d 0.86), moderate effect-size improvements in physical function (d 0.66), and small effect-size improvements in body composition (d 0.28) and QoL (d 0.25) outcomes. The effect sizes observed following RE are comparable in magnitude to the effects of exercise interventions reported in prior comprehensive reviews of the exercise cancer literature which primarily focused upon AE. Additionally, the methodologic quality of the studies was generally strong. Taken collectively, results of this systematic review suggest that RE is a promising supportive care intervention that results in meaningful improvements in clinically relevant physiologic and QoL outcomes during and following cancer treatment.

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Resistance exercise interventions during and following cancer treatment: a systematic review
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Resistance exercise interventions during and following cancer treatment: a systematic review
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