转移性去势抵抗性前列腺癌男性患者居家运动训练的可行性
Feasibility of home-based exercise training in men with metastatic castration-resistant prostate cancer.
作者信息
Hanson Erik D, Alzer Mohamdod, Carver Jackson, Stopforth Cameron K, Lucas Alexander R, Whang Young E, Milowsky Matthew I, Bartlett David B, Harrison Michael R, Bitting Rhonda L, Deal Allison M, Stoner Lee, Hackney A C, Battaglini Claudio L
机构信息
Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
出版信息
Prostate Cancer Prostatic Dis. 2023 Jun;26(2):302-308. doi: 10.1038/s41391-022-00523-8. Epub 2022 Mar 19.
BACKGROUND
Home-based training increases accessibility to exercise and mitigates the side effects of hormone therapy for prostate cancer (PC). However, it is unknown if men with more advanced disease are willing to partake in such interventions.
PURPOSE
To determine the feasibility of a home-based exercise intervention in men with metastatic castration-resistant prostate cancer (mCRPC).
METHODS
mCRPC patients on androgen receptor signaling inhibitors (ARSI) were prescribed a 12-week, home-based exercise intervention using resistance bands and walking. Feasibility was assessed using recruitment, retention, adherence, and outcome capture. Physiological changes and patient reported outcomes were assessed before and after the intervention.
RESULTS
Of the 62 referrals, 47 were eligible with 22 men performing baseline testing (47% recruitment rate) and 16 completing the intervention (73% retention). Task completion was >86% for all physiological tests. Walking adherence was 80% and resistance training was 63%, the latter falling short of the study target (75%). Training increased thigh muscle cross-sectional area by 22%, time to exhaustion by 19% (both p < 0.05) and peak oxygen uptake by 6% (p = 0.057). Improvements in short physical performance battery scores and 400 m walk demonstrated moderate effect sizes that did not reach significance.
CONCLUSIONS
Home-based exercise is feasible during ARSI treatment for mCRPC. Greater endurance capacity and localized hypertrophy appear as the primary improvements following training. These preliminary findings suggest home-based training may increase exercise accessibility, with important lessons that will inform subsequent trials investigating the efficacy of home-based exercise interventions during mCRPC.
背景
居家训练增加了运动的可及性，并减轻了前列腺癌（PC）激素治疗的副作用。然而，疾病进展更严重的男性是否愿意参与此类干预尚不清楚。
目的
确定居家运动干预对转移性去势抵抗性前列腺癌（mCRPC）男性患者的可行性。
方法
为正在接受雄激素受体信号抑制剂（ARSI）治疗的mCRPC患者制定了一项为期12周的居家运动干预方案，使用弹力带和步行。通过招募、留存率、依从性和结果获取来评估可行性。在干预前后评估生理变化和患者报告的结果。
结果
在62名被转诊者中，47名符合条件，22名男性进行了基线测试（招募率47%），16名完成了干预（留存率73%）。所有生理测试的任务完成率均>86%。步行依从性为80%，阻力训练为63%，后者未达到研究目标（75%）。训练使大腿肌肉横截面积增加了22%，力竭时间增加了19%（均p<0.05），峰值摄氧量增加了6%（p=0.057）。简短体能测试分数和400米步行的改善显示出中等效应量，但未达到显著水平。
结论
在ARSI治疗mCRPC期间，居家运动是可行的。训练后，耐力和局部肥大的改善较为明显。这些初步研究结果表明，居家训练可能会增加运动的可及性，为后续研究mCRPC期间居家运动干预效果的试验提供重要经验教训。
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