Objectives To explore the effects of 12 weeks of unsupervised home‐based ‘exergaming’ (i.e., technology‐driven exercise) compared to usual care on physical function, body composition, quality of life (QoL), and fatigue in patients with prostate cancer on androgen‐deprivation therapy (ADT). Patients and methods In an assessor‐blinded randomised controlled trial, 46 patients with prostate cancer (aged >65 years) with locally advanced or advanced stage disease undergoing ADT were randomised to 12 weeks of unsupervised home‐based exergaming or usual care from two hospitals in Denmark. The primary outcome of the study was 6‐min walking test (6MWT). Secondary outcomes were leg extensor power (LEP), body composition (lean‐ and fat‐mass), self‐reported physical functioning and global health status (European Organisation for Research and Treatment of Cancer quality of life questionnaire 30‐item core [EORTC QLQ‐C30]), QoL (Functional Assessment of Cancer Therapy – Prostate [FACT‐P]) and fatigue (FACT – fatigue [FACT‐F]). Results There was significant improvement in the exergaming group compared to the usual care group in the primary outcome of 6MWT (mean difference: 21.5 m; 95% confidence interval ([CI]) 3.2–39.9; P = 0.023). There were no differences between the groups for LEP (P = 0.227), lean body mass (P = 0.100), fat body mass (P = 0.092), self‐reported physical functioning (P = 0.084) and global health status (P = 0.113), QoL (P = 0.614), and fatigue (P = 0.147). Conclusion Unsupervised home‐based exergaming for 12 weeks had an effect on the primary outcome of 6MWT in patients with prostate cancer receiving ADT. However, no significant effects were found in secondary outcomes. The exergaming intervention appeared safe and could be an alternative to traditional aerobic and resistance training in this patient group.

Background Androgen deprivation therapy (ADT) in patients with prostate cancer can have several debilitating side effects. Supervised exercise is recommended to ameliorate these negative effects. Objective To systematically evaluate the effect of supervised exercise therapy compared to no exercise therapy in patients with prostate cancer undergoing ADT, primarily according to the patient critical outcomes, ‘disease-specific quality of life’ and ‘walking performance’ measured at end of treatment. Methods We searched PubMed/Medline, Embase, Cochrane Library, Cinahl and Pedro, to identify randomised controlled trials (RCTs), which investigated the effect of supervised exercise therapy compared to no exercise therapy in patients with prostate cancer receiving ADT, last search: June 2021. Two independent reviewers extracted data, and assessed risk of bias using Cochrane Risk of Bias Tool and evaluated the certainty of evidence using the GRADE-method. Results Eigthteen RCTs (n = 1477) comprised patients with prostate cancer stages T1-T4 were included in the meta-analyses. Compared to no exercise therapy, supervised exercise therapy showed clinically relevant improvements in ‘disease-specific quality of life’ and ‘walking performance’. The standardised mean differences were 0.43 (95% confidence interval (CI): 0.29, 0.58) and −0.41 (95% CI: −0.60, −0.22), respectively. The overall certainty of evidence was moderate due to serious risk of bias. Conclusions Evidence of moderate quality shows that supervised exercise therapy probably is superior to no exercise therapy in improving ‘disease-specific quality of life’ and ‘walking performance’ in patients with prostate cancer undergoing ADT. The results apply to all patients receiving androgen deprivation therapy regardless of cancer stage. The results support a strong recommendation for supervised exercise therapy for managing side effects in this population. Protocol registration NKR-38-Focused-questions-PICOs-for-updating1.ashx (sst.dk)

video gaming console. This study will therefore be able to provide information about a novel exercise modality for this patient group.To establish a solid basis for this study, a literature review was conducted in the PubMed, Cochrane, Cinahl and PsychInfo databases to establish the magnitude of the problem regarding the adverse effects of androgen deprivation therapy and to what extent exercise can improve these conditions.Prostate cancer is treated with androgen deprivation therapy combined with curative radiation therapy or androgen deprivation therapy alone if metastatic disease is present at the time of diagnosis [2]. The treatment reduces the production of testosterone but has adverse effects such as hypercholesterolemia, obesity, type 2 diabetes, osteoporosis, loss of muscle mass and muscle strength, decreased quality of life, increased risk of cardio-vascular disease and increased fatigue [3][4][5][6]. Some of these adverse effects are part of the metabolic syndrome, and newer studies show that the metabolic syndrome occurs in more than 50 per cent of men receiving long-term androgen deprivation therapy [7]. A significant correlation is seen between the duration of treatment and the degree of insulin resistance, level of fasting glucose and increase in waist circumference [8].Resistance and aerobic exercises increase muscle mass, muscle strength, cardio-vascular fitness and walking distance; decrease levels of insulin-like growth factor-I (IGF-1); improve quality of life, physical function, suppleness and haemoglobin percentage; and strengthen the immune system [9,10]. Studies also show that less nausea and fatigue, fewer disease symptoms, less fat mass, a lower pulse rate and systolic blood pressure is seen in patients who exercise [11,12]. Therefore resistance and aerobic exercises are successful in preventing the adverse effects of androgen deprivation therapy, but this type of exercise is usually not performed in the home setting.

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