Nilsen Tormod S, Raastad Truls, Skovlund Eva, Courneya Kerry S, Langberg Carl W, Lilleby Wolfgang, Fosså Sophie D, Thorsen Lene
a Department of Physical Performance , Norwegian School of Sport Sciences , Oslo , Norway.
b Norwegian Institute of Public Health and School of Pharmacy, University of Oslo , Oslo , Norway.
Acta Oncol. 2015 Nov;54(10):1805-13. doi: 10.3109/0284186X.2015.1037008. Epub 2015 Apr 30.
Androgen deprivation therapy (ADT) increases survival rates in prostate cancer (PCa) patients with locally advanced disease, but is associated with side effects that may impair daily function. Strength training may counteract several side effects of ADT, such as changes in body composition and physical functioning, which in turn may affect health-related quality of life (HRQOL). However, additional randomised controlled trials are needed to expand this knowledge.
Fifty-eight PCa patients on ADT were randomised to either 16 weeks of high-load strength training (n = 28) or usual care (n = 30). The primary outcome was change in total lean body mass (LBM) assessed by dual x-ray absorptiometry (DXA). Secondary outcomes were changes in regional LBM, fat mass, and areal bone mineral density (aBMD) measured by DXA; physical functioning assessed by 1-repetition maximum (1RM) tests, sit-to-stand test, stair climbing test and Shuttle walk test; and HRQOL as measured by the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30.
No statistically significant effect of high-load strength training was demonstrated on total LBM (p = 0.16), but significant effects were found on LBM in the lower and upper extremities (0.49 kg, p < 0.01 and 0.15 kg, p < 0.05, respectively). Compared to usual care, high-load strength training showed no effect on fat mass, aBMD or HRQOL, but beneficial effects were observed in all 1RM tests, sit-to-stand test and stair climbing tests. Adherence to the training program was 88% for lower body exercises and 84% for upper body exercises. In summary, high-load strength training improved LBM in extremities and physical functioning, but had no effect on fat mass, aBMD, or HRQOL in PCa patients on ADT.
雄激素剥夺疗法(ADT)可提高局部晚期前列腺癌(PCa)患者的生存率,但会产生一些可能影响日常功能的副作用。力量训练可能会抵消ADT的一些副作用,如身体成分和身体功能的变化,而这些变化反过来又可能影响健康相关生活质量(HRQOL)。然而,需要更多的随机对照试验来扩充这方面的知识。
58名接受ADT的PCa患者被随机分为两组,一组进行16周的高负荷力量训练(n = 28),另一组接受常规护理(n = 30)。主要结局是通过双能X线吸收法(DXA)评估的总体瘦体重(LBM)变化。次要结局包括通过DXA测量的局部LBM、脂肪量和骨矿物质密度(aBMD)变化;通过1次重复最大量(1RM)测试、坐立试验、爬楼梯试验和往返步行试验评估的身体功能;以及通过欧洲癌症研究与治疗组织生活质量问卷核心30项量表测量的HRQOL。
高负荷力量训练对总体LBM没有统计学上的显著影响(p = 0.16),但对下肢和上肢的LBM有显著影响(分别为0.49 kg,p < 0.01和0.15 kg,p < 0.05)。与常规护理相比,高负荷力量训练对脂肪量、aBMD或HRQOL没有影响,但在所有1RM测试、坐立试验和爬楼梯试验中观察到有益效果。下肢训练项目的依从率为88%,上肢训练项目的依从率为84%。总之,高负荷力量训练改善了接受ADT的PCa患者四肢的LBM和身体功能,但对脂肪量、aBMD或HRQOL没有影响。