Effects Of Exercise On Disablement Process Outcomes In Prostate Cancer Patients Undergoing Androgen Deprivation Therapy: An Updated Systematic Review

Abstract

Although androgen-deprivation therapy (ADT) is a foundation of treatment for prostate cancer (PCa) patients, adverse effects of ADT may accelerate functional decline. Whereas exercise improves muscular strength and functional performance in PCa patients, evidence of the benefits of exercise for alternative disablement process outcomes remain equivocal. PURPOSE: To update the findings of our previous systematic review of the effects of exercise on disablement process outcomes in PCa patients undergoing ADT. The purpose of this study is to determine the extent to which exercise interventions produce meaningful improvements in the specific impairment domain outcome of body composition (BC) in PCa patients on ADT. METHODS: A comprehensive literature search was conducted of all relevant published studies from December 2013-present. Data were extracted on BC outcomes from 8 published exercise intervention studies involving 307 PCa patients on ADT. The magnitude of pre- to post-intervention change was examined. To isolate the effects of exercise, studies combining other interventions were excluded. Weighted, bias-corrected Cohen’s d effect sizes were calculated for change in each outcome and averaged across included studies. RESULTS: Results revealed that exercise yielded small average improvements in lean body mass (d = 0.09), appendicular lean mass (d = 0.08), trunk fat mass (d = -0.03) and visceral fat mass (d = -0.11). All other measures of whole-body and regional BC showed negligible average effects of exercise. CONCLUSIONS: The findings of this updated systematic review suggest that while exercise attenuates the established adverse effects of ADT on BC, the magnitude of exercise-induced improvements in BC outcomes is small and inconsistent across studies. These findings have important implications for delineating the effect of exercise on disablement process outcomes and underscore the potential utility of complementing exercise with targeted nutritional approaches in the supportive care of PCa patients on ADT.