Department of Epidemiology and Biostatistics, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.
Edith Cowan University Health and Wellness Institute, Edith Cowan University, Joondalup, Western Australia, Australia.
Cancer. 2015 Aug 15;121(16):2821-30. doi: 10.1002/cncr.29406. Epub 2015 Apr 17.
The current study examined effects, moderators (for whom), and mediators (working mechanisms) of 12 months of exercise on health-related quality of life (HRQoL) in older long-term survivors of prostate cancer.
In total, 100 men aged 71.7 years (standard deviation, 6.4 years) were randomly assigned to 6 months of supervised aerobic and resistance exercise followed by 6 months of a home-based exercise maintenance program (EX group) or printed education material regarding physical activity for 12 months (PA group). Assessments took place at baseline and after 6 and 12 months. Generalized estimating equations were used to study the effects of EX versus PA on HRQoL at 6 and 12 months, adjusting for baseline HRQoL. The authors examined potential sociodemographic and clinical moderators by adding interaction terms, and potential physical and psychological mediators using the product-of-coefficients test.
At 6 months, significant beneficial effects were found for global QoL, physical function, and social function in the EX group compared with the PA group. For physical function, beneficial effects were sustained at 12 months. Moderation analyses demonstrated larger effects of EX versus PA for patients who were married, started exercising sooner after their diagnosis, and previously used bisphosphonates. Changes in lower body functional performance significantly mediated the effect of EX on global QoL, physical function, and social function. No mediating effects on HRQoL were found for aerobic fitness, physical activity, fatigue, distress, or falls self-efficacy.
Aerobic and resistance exercise appears to have beneficial effects on HRQoL among older, long-term survivors of prostate cancer. Effects were moderated by marital status, time since diagnosis, and use of bisphosphonates, and were mediated by lower body functional performance.
本研究旨在探讨 12 个月运动对前列腺癌长期幸存者健康相关生活质量（HRQoL）的影响、调节因素（针对哪些人群）和中介因素（作用机制）。
共纳入 100 名年龄为 71.7 岁（标准差为 6.4 岁）的男性，他们被随机分配至 6 个月的监督有氧运动和抗阻运动，随后进行 6 个月的家庭锻炼维持方案（EX 组），或接受 12 个月的有关体力活动的印刷教育材料（PA 组）。在基线、6 个月和 12 个月时进行评估。使用广义估计方程来研究 EX 与 PA 对 6 个月和 12 个月时 HRQoL 的影响，调整了基线 HRQoL。作者通过添加交互项来检查潜在的社会人口学和临床调节因素，通过乘积系数检验来检查潜在的身体和心理中介因素。
在 6 个月时，EX 组在总体 QoL、身体功能和社会功能方面的效果明显优于 PA 组。在 12 个月时，身体功能的有益效果仍持续存在。调节分析表明，对于已婚、在诊断后更早开始运动以及之前使用双膦酸盐的患者，EX 相对于 PA 的效果更大。下肢功能表现的变化显著介导了 EX 对总体 QoL、身体功能和社会功能的影响。在 HRQoL 方面，未发现有氧运动能力、体力活动、疲劳、痛苦或跌倒自我效能的中介作用。
有氧运动和抗阻运动似乎对前列腺癌长期幸存者的 HRQoL 具有有益的影响。这些效果受婚姻状况、诊断后时间和双膦酸盐使用的调节，通过下肢功能表现来介导。
