Sajid Saleha, Dale William, Mustian Karen, Kotwal Ashwin, Heckler Charles, Porto Michelle, Fung Chunkit, Mohile Supriya G
Department of Medicine, Section of Geriatrics & Palliative Medicine, and Hematology/Oncology, University of Chicago, Chicago, IL, USA.
Department of Medicine, James Wilmot Cancer Institute, University of Rochester, Rochester, NY, USA.
J Geriatr Oncol. 2016 Mar;7(2):71-80. doi: 10.1016/j.jgo.2016.02.002. Epub 2016 Feb 23.
Androgen deprivation therapy (ADT) can decrease the physical performance (PP) of older men with prostate cancer (PC).
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.
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.
A home-based aerobic and resistance exercise program, EXCAP, shows promise for improving PP in older men with PC on ADT.
雄激素剥夺疗法(ADT)会降低老年前列腺癌(PC)患者的身体机能(PP)。
我们开展了一项三臂随机试点研究(n = 19),将一项居家步行和阻力干预(EXCAP)以及一项使用Wii Fit的技术介导步行和阻力干预与接受ADT的≥70岁PC男性的常规护理组进行比较。干预持续6周,在12周时进行随访。预先设定的主要结局是简短身体机能量表(SPPB)评分的变化。使用混合效应回归模型评估随时间推移结局的变化。
参与者的平均年龄为70岁(范围:67 - 93岁)。8名患者被随机分配到Wii Fit组,6名到EXCAP组,5名到常规护理组。常规护理组的SPPB评分几乎保持不变(β = -0.12;p = 0.79),而EXCAP组的个体在每次随访时平均增加1.2分(β = 1.20;95% CI:0.36,2.06)。与常规护理相比,Wii Fit组的SPPB评分随时间增加不显著(β = 0.32;95% CI -0.43,1.06;p = 0.46)。与常规护理组相比,EXCAP组个体每天的步数随时间增加(p值 = 0.006);EXCAP组增加了2720步(95% CI:1313,4128),而常规护理组增加了97步(95% CI:-1140,1333)。Wii Fit组的参与者增加了1020步(95% CI:-474,1238,p = 0.710)。其他结局(即握力、瘦肌肉量和卧推重复次数)无统计学意义。
一项居家有氧运动和阻力运动计划EXCAP,有望改善接受ADT的老年PC男性的身体机能。