Supported progressive resistance exercise training to counter the adverse side effects of robot-assisted radical prostatectomy: a randomised controlled trial

Abstract

Purpose To investigate the effects of a supported home-based progressive resistance exercise training (RET) programme on indices of cardiovascular health, muscular strength and health-related quality of life (HR-QoL) in prostate cancer (PCa) patients after treatment with robot-assisted radical prostatectomy (RARP). Methods This study was a single-site, two-arm randomised controlled trial, with 40 participants randomised to either the intervention or control group over a 10-month period. In addition to receiving usual care, the intervention group completed three weekly RET sessions using resistance bands for 6 months. Participants performed 3 sets of 12–15 repetitions for each exercise, targeting each major muscle group. The control group received usual care only. Brachial artery flow-mediated dilatation (FMD) was the primary outcome and assessed at baseline, 3 and 6 months. Secondary outcomes included body weight, body fat, aerobic fitness, strength and blood-borne biomarkers associated with cardiometabolic risk. Results There was no significant difference between the groups in FMD at 3 or 6 months. However, there were improvements in aerobic exercise capacity (P < 0.01) and upper- (P < 0.01) and lower-limb (P = 0.01) strength in favour of the RET group at 6 months, accompanied by greater weight loss (P = 0.04) and a reduction in body fat (P = 0.02). Improvements in HRQoL were evident in the RET group at 3 and 6 months via the PCa-specific component of the FACT-P questionnaire (both P < 0.01). Five adverse events and one serious adverse event were reported throughout the trial duration. Conclusion This study demonstrates that home-based RET is an effective and safe mode of exercise that elicits beneficial effects on aerobic exercise capacity, muscular strength and HR-QoL in men who have undergone RARP. Trial registration ISRCTN10490647.

Exercise medicine for cancer cachexia: targeted exercise to counteract mechanisms and treatment side effects

“…Curative cancer treatment often involves surgery, which can cause further health complications and increase risk for other conditions. For example, after cancer-related surgeries for lung, prostate, and colorectal cancer, patients have increased risks of cardiovascular-related events, post-operative complications, and suffer large reductions in muscle mass and strength (Singh et al 2017 ; Ashton et al 2021 ). This can be particularly detrimental during CC, as it further accelerates muscle wasting, and significantly decreases survival (Choi et al 2018 ).…”

“…This can be particularly detrimental during CC, as it further accelerates muscle wasting, and significantly decreases survival (Choi et al 2018 ). Exercise is safe and effective for improving aerobic exercise capacity, muscle strength, and health-related quality of life after prostatectomy (Singh et al 2017 ; Ashton et al 2021 ). For example, 6 weeks (2 week −1 ) of RET and 20 min of LICET increased muscle strength (24%), which was maintained post-surgery (Singh et al 2017 ), however, it is impossible to make inferences about its effectiveness in attenuating the 2.7 kg loss of muscle experienced post-surgery, as there was no non-exercising group.…”

“…For example, 6 weeks (2 week −1 ) of RET and 20 min of LICET increased muscle strength (24%), which was maintained post-surgery (Singh et al 2017 ), however, it is impossible to make inferences about its effectiveness in attenuating the 2.7 kg loss of muscle experienced post-surgery, as there was no non-exercising group. In a similar study with the inclusion of a non-exercising group, exercise not only improved endurance exercise capacity and muscle strength after prostatectomy but also prevented increases in weight and fat mass occurring in the non-exercising group (Ashton et al 2021 ). Systematic reviews have indicated that pre-surgical exercise for patients with prostate, lung, colorectal, colon, pancreatic, and bladder cancer may improve pre- and post-operative physical capacity, muscular strength, and quality of life, and decrease length of hospital stay, and post-operative complications (Singh et al 2017 ).…”

The influence of lifestyle changes (diet, exercise and stress reduction) on prostate cancer tumour biology and patient outcomes: A systematic review

“…46 Of the 10 studies demonstrating a benefit to mental health, 7 focused on PA alone. 47,48,55,58,59 Mental health assessment metrics were evaluated using several different validated measurement tools (see Table 1.). 47,48,55,58,59 F I G U R E 3 Mosaic plot representing the proportions of successful interventions by type on mental health outcomes for prostate cancer (PCa) patients for all studies summarised in Table 1.…”

“…Farris et al 48 investigated 817 PCa patients (74.1% and 15.9% with localised and advanced disease respectively) assessing their PA at 3 separate time points over 36 months from diagnosis and found those who adhered to the guidelines of moderate to vigorous PA (150 min moderate or 75 min vigorous per week) reported better QOL scores as assessed by the SF‐36. The other 5 successful PA‐focused studies examined predominantly patients with localised PCa with PA interventions of 2–6 months including regimes of 3 weekly sessions of resistance exercise training using resistance bands, combined group and individual sessions 4 times per week, supervised HIIT programmes, training twice a week at a local football club and moderate PA 5 days per week 47,48,55,58,59 . Mental health assessment metrics were evaluated using several different validated measurement tools (see Table 1.)…”