Lopez Pedro, Taaffe Dennis R, Newton Robert U, Galvão Daniel A
Med Sci Sports Exerc. 2021 Mar 1;53(3):459-469. doi: 10.1249/MSS.0000000000002503.
Resistance exercise improves an array of treatment-related adverse effects in men with prostate cancer; however, the minimal dosage required is unknown. We systematically reviewed the resistance training effects in prostate cancer patients to determine the minimal dosage regarding the exercise components (type, duration, volume, and intensity) on body composition, physical function, muscle strength, cardiorespiratory fitness, body mass index, and prostate-specific antigen.
Using PRISMA guidelines, MEDLINE, CINAHL, EMBASE, SPORTDiscus, and Web of Science databases were searched. Eligible randomized controlled trials examined prostate cancer patients undertaking resistance-based exercise programs during or after treatment. Meta-analysis was undertaken when more than three studies were included. Associations between mean differences and exercise components were tested by univariate and multivariate meta-regression analysis.
Twenty-three articles describing 21 trials and involving 1748 prostate cancer patients were included. Exercise improved fat mass (-1% in body fat and -0.6 kg in fat mass), lean mass (~0.5 kg in lean and appendicular lean mass), functional capacity (i.e., chair rise, 400-m test, 6-m fast walk, and stair climb tests), and fitness outcomes (i.e., V̇O2peak and muscle strength) (P = 0.040-<0.001) with no change in body mass index or prostate-specific antigen (P = 0.440-0.735). Meta-regression indicated no association between exercise type, resistance training duration, weekly volume and intensity, and primary outcomes (P = 0.075-0.965). There was a significant association between exercise intensity and chest press muscle strength (favoring moderate intensity, P = 0.012), but not in other secondary outcomes.
In untrained older men with prostate cancer initiating an exercise program, lower volume at moderate to high intensity is as effective as higher volume resistance training for enhancing body composition, functional capacity, and muscle strength in the short term. A low exercise dosage may help reduce barriers to exercise and enhance adherence.
抗阻运动可改善前列腺癌男性患者一系列与治疗相关的不良反应；然而，所需的最小剂量尚不清楚。我们系统回顾了前列腺癌患者的抗阻训练效果，以确定运动组成部分（类型、持续时间、运动量和强度）对身体成分、身体功能、肌肉力量、心肺适能、体重指数和前列腺特异性抗原的最小剂量。
按照PRISMA指南，检索了MEDLINE、CINAHL、EMBASE、SPORTDiscus和Web of Science数据库。符合条件的随机对照试验研究了在治疗期间或治疗后进行抗阻运动计划的前列腺癌患者。当纳入超过三项研究时进行荟萃分析。通过单变量和多变量荟萃回归分析测试平均差异与运动组成部分之间的关联。
纳入了23篇文章，描述了21项试验，涉及1748例前列腺癌患者。运动改善了脂肪量（体脂减少1%，脂肪量减少0.6 kg）、去脂体重（瘦体重和四肢瘦体重增加约0.5 kg）、功能能力（即从椅子上起身、400米测试、6米快速步行和爬楼梯测试）以及适能指标（即峰值摄氧量和肌肉力量）（P = 0.040 - <0.001），而体重指数或前列腺特异性抗原无变化（P = 0.440 - 0.735）。荟萃回归表明运动类型、抗阻训练持续时间、每周运动量和强度与主要结局之间无关联（P = 0.075 - 0.965）。运动强度与胸推肌肉力量之间存在显著关联（有利于中等强度，P = 0.012），但在其他次要结局中不存在。
对于刚开始运动计划的未经训练的老年前列腺癌男性患者，在短期内，中等至高强度下较低的运动量与较高的运动量抗阻训练在改善身体成分、功能能力和肌肉力量方面同样有效。低运动剂量可能有助于减少运动障碍并提高依从性。
