Combined aerobic and resistance training improves bone health of female cancer survivors

Abstract

IntroductionCancer pathogenesis and resulting treatment may lead to bone loss and poor skeletal health in survivorship. The purpose of this investigation was to evaluate the influence of 26 weeks of combined aerobic and resistance-training (CART) exercise on bone mineral density (BMD) in a multi-racial sample of female cancer survivors.MethodsTwenty-six female cancer survivors volunteered to undergo CART for 1 h/day, 3 days/week, for 26 weeks. The Improving Physical Activity After Cancer Treatment (IMPAACT) Program involves supervised group exercise sessions including 20 min of cardiorespiratory training, 25 min of circuit-style resistance-training, and 15 min of abdominal exercises and stretching. BMD at the spine, hip, and whole body was assessed using dual-energy X-ray absorptiometry (DXA) before and after the intervention. Serum markers of bone metabolism (procollagen-type I N-terminal propeptide, P1NP, and C-terminal telopeptides, CTX) were measured at baseline, 13 weeks, and at study completion.ResultsEighteen participants, with the average age of 63.0 ± 10.3 years, completed the program. Mean duration since completion of cancer treatment was 6.2 ± 10.6 years. Paired t-tests revealed significant improvements in BMD of the spine (0.971 ± 0.218 g/cm2 vs. 0.995 ± 0.218 g/cm2, p = 0.012), hip (0.860 ± 0.184 g/cm2 vs. 0.875 ± 0.191 g/cm2, p = 0.048), and whole body (1.002 ± 0.153 g/cm2 vs. 1.022 ± 0.159 g/cm2, p = 0.002). P1NP declined 22% at 13 weeks and 28% at 26 weeks in comparison to baseline (p < 0.01) while CTX showed a non-significant decrease of 8% and 18% respectively.ConclusionsWe report significant improvements in BMD at the spine, hip, and whole body for female cancer survivors who completed 26 weeks of CART. This investigation demonstrates the possible effectiveness of CART at improving bone health and reducing risk of osteoporosis for women who have completed cancer treatment. The IMPAACT Program appears to be a safe and feasible way for women to improve health after cancer treatment.

Musculoskeletal Outcomes from Chronic High-Speed, High-Impulse Resistance Exercise

“…Based on the variables that improved, our hypothesis was partially affirmed. Pre-post increases to left calcaneal BMC and BMD far exceed gains seen previously and may be due to a significant decline in bone resorption [2,19,58]. It is important to explain why our BMC and BMD results 1): yielded greater gains than other studies, and 2): were confined to the calcaneus.…”

“…This led some to imply power train-ing, with its high movement rates and impact forces, was better for osteogenesis [14,16,24,33]. A combined 26-week aerobic and resistive exercise intervention produced modest ( + 1.7-2.5 %) BMD gains in female cancer survivors [2]. Impact forces from tennis (averaged 14.3 years of play) led to dominant arm muscle volume ( + 9.7 %) and BMC ( + 13.5 %) gains versus the non-dominant arm [18].…”

Effect of exercise on bone in poorly controlled type 1 diabetes mediated by the ActRIIB/Smad signaling pathway

“…Skeletal disorders are common in diabetic patients, and many researchers have found that the patients had reduced bone mineral content (24,25), deranged calcium and phosphate levels, and altered bone metabolism (26,27). While it has been proven that aerobic and resistance training improves bone health (28,29), there are only a few studies that have reported the effects of weight-bearing treadmill running on diabetes-induced bone loss. In accordance with the previous studies (30-32), we found that weight-bearing treadmill treatment reduced STZ-induced blood glucose, and increased STZ-induced blood insulin, weight mass, muscle mass, bone mass, and grip strength.…”

Cancer‐ and Chemotherapy‐Induced Musculoskeletal Degradation

“…Resistance and aerobic exercise training have been shown to preserve or improve bone density in cancer survivors and patients actively undergoing hormone therapy . Twenty‐six weeks of combined aerobic and resistance training has shown benefit for female cancer survivors in improved spine, hip, and whole body bone mineral density (BMD), but these results were not stratified by type of cancer or cancer therapy during primary tumor treatment . In another study, again not stratified by tumor type or treatment, 24 months of strength and weight training showed improved balance and muscle strength in breast cancer survivors .…”