School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia.
J Cancer Res Clin Oncol. 2023 Dec;149(18):16563-16573. doi: 10.1007/s00432-023-05409-3. Epub 2023 Sep 15.
The study compared the efficacy of commencing supervised exercise in men with prostate cancer before and after prostatectomy on objective and patient-reported outcomes, hospital length of stay, and urinary incontinence.
Forty-one men were randomised to a 6-week prehabilitation or rehabilitation exercise programme. Prehabilitation involved resistance and aerobic exercise thrice weekly pre-surgery, while rehabilitation comprised the same commencing 6-weeks post-surgery. Assessments included strength, function (chair rise, stair climb, 400-m, 6-m usual, fast, and backwards walk), body composition, fatigue and quality of life, undertaken at pre-surgery, early post-surgery and late post-surgery phase, with urinary incontinence (24-h pad test) assessed at 2, 6, and 12-weeks post-surgery. Intention-to-treat and sensitivity analyses were undertaken.
Of thirty-eight men (48-73 years), 29 completed all assessments with most undergoing robotic-assisted laparoscopic prostatectomy (92.1%). In the pre-surgery phase, prehabilitation improved muscle strength (leg press: 17.2 kg; chest press: 2.9 kg; p ≤ 0.001), 400-m, chair rise, 6-m fast and backward walk tests (p ≤ 0.001-0.028). Strength and function declines in the early post-surgery phase were maintained late post-surgery. Rehabilitation showed declines of these outcomes after surgery with improvement late post-surgery (leg press: 14.6 kg, p < 0.001; chest press: 6.8 kg, p < 0.001; 400-m walk: -12.0 s, p = 0.005), resulting in no difference between groups at 12 weeks. There were no significant differences between groups for patient-reported outcomes, hospital length of stay or urinary incontinence.
Pre-surgical exercise enhanced strength and function, protecting against post-surgery declines. Although exercise post-surgery is beneficial for recouping strength and function, where possible men undergoing prostatectomy are encouraged to exercise pre-surgery.
ACTRN12617001115325 registered 31 July 2017.
本研究比较了前列腺癌患者前列腺切除术前和术后接受监督下运动锻炼对客观和患者报告结果、住院时间和尿失禁的疗效。
41 名男性随机分为 6 周的术前预康复或术后康复运动方案组。预康复包括术前每周三次进行阻力和有氧运动，而康复则包括术后 6 周开始进行相同的运动。评估包括力量、功能（坐起、爬楼梯、400 米、6 米常速、快速和向后走）、身体成分、疲劳和生活质量，分别在术前、术后早期和术后晚期进行，术后 2、6 和 12 周进行尿失禁（24 小时垫试验）评估。进行意向治疗和敏感性分析。
38 名男性（48-73 岁）中的 29 名完成了所有评估，其中大多数接受了机器人辅助腹腔镜前列腺切除术（92.1%）。在术前阶段，预康复改善了肌肉力量（腿推：17.2 公斤；胸推：2.9 公斤；p≤0.001）、400 米、坐起、6 米快速和向后走测试（p≤0.001-0.028）。术后早期阶段的力量和功能下降在术后晚期仍保持不变。康复后手术的结果显示这些结果下降，术后晚期改善（腿推：14.6 公斤，p<0.001；胸推：6.8 公斤，p<0.001；400 米走：-12.0 秒，p=0.005），因此在 12 周时两组之间没有差异。两组间患者报告的结果、住院时间或尿失禁无显著差异。
术前运动增强了力量和功能，防止了术后的下降。尽管术后运动对恢复力量和功能有益，但鼓励接受前列腺切除术的男性尽可能在术前进行运动。
ACTRN12617001115325 于 2017 年 7 月 31 日注册。
