Skeletal response to resistance and impact training in prostate cancer survivors

Kerri Winters-Stone, Jessica C. Dobek, Jill Bennett, Gianni F. Maddalozzo, Christopher Ryan, Tomasz (Tom) Beer

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Introduction: Androgen deprivation therapy (ADT) is associated with significant bone loss and an increase in fracture risk among prostate cancer survivors (PCS). We investigated whether impact + resistance training could stop ADT-related declines in bone mineral density (BMD) among PCS on ADT. Methods: We randomized 51 PCS (mean age, 70.2 yr) currently prescribed ADT to participate in 1 yr of impact + resistance training (Prevent Osteoporosis with Impact + Resistance (POWIR)) or in an exercise placebo program of stretching exercise (FLEX). Outcomes were proximal femur (total hip, femoral neck, and greater trochanter) and spine (L1-L4) BMD (gIcm-2) and bone turnover markers (serum osteocalcin (ngImL-1) and urinary deoxypyrodinoline cross-links (nmolImmol-1 Cr)). Results: Retention in the 1-yr study was 84% and median attendance to supervised classes was 84% in POWIR and 74% in FLEX. No study-related injuries were reported. There were no significant differences between groups for average L1-L4 BMD or for BMD at any hip site. When examining individual vertebrae, POWIR has a significant effect on preservation of BMD (j0.4%) at the L4 vertebrae compared with losses (j3.1%) in FLEX (P = 0.03). Conclusion: Impact + resistance training was a safe and acceptable form of exercise for older PCS on ADT. Among our limited sample, POWIR did not appear to have a clinically meaningful effect on hip or spine BMD, but some evidence of skeletal adaptation to resistance + impact training in an androgen-deprived state was apparent. Future studies need to be conducted on a larger sample of patients and should consider modifications to POWIR that could further enhance loading across the spine and at the hip to preserve BMD at these clinically relevant sites.

Original languageEnglish (US)
Pages (from-to)1482-1488
Number of pages7
JournalMedicine and Science in Sports and Exercise
Volume46
Issue number8
DOIs
StatePublished - 2014

Fingerprint

Resistance Training
Bone Density
Prostatic Neoplasms
Androgens
Osteoporosis
Spine
Hip
Exercise
Femur
Therapeutics
Bone Remodeling
Femur Neck
Osteocalcin
Biomarkers
Placebos
Bone and Bones
Wounds and Injuries

Keywords

  • Androgen deprivation therapy
  • Cancer survivor
  • fracture
  • Osteoporosis
  • Physical activity
  • Weight training

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Medicine(all)

Cite this

Skeletal response to resistance and impact training in prostate cancer survivors. / Winters-Stone, Kerri; Dobek, Jessica C.; Bennett, Jill; Maddalozzo, Gianni F.; Ryan, Christopher; Beer, Tomasz (Tom).

In: Medicine and Science in Sports and Exercise, Vol. 46, No. 8, 2014, p. 1482-1488.

Research output: Contribution to journalArticle

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abstract = "Introduction: Androgen deprivation therapy (ADT) is associated with significant bone loss and an increase in fracture risk among prostate cancer survivors (PCS). We investigated whether impact + resistance training could stop ADT-related declines in bone mineral density (BMD) among PCS on ADT. Methods: We randomized 51 PCS (mean age, 70.2 yr) currently prescribed ADT to participate in 1 yr of impact + resistance training (Prevent Osteoporosis with Impact + Resistance (POWIR)) or in an exercise placebo program of stretching exercise (FLEX). Outcomes were proximal femur (total hip, femoral neck, and greater trochanter) and spine (L1-L4) BMD (gIcm-2) and bone turnover markers (serum osteocalcin (ngImL-1) and urinary deoxypyrodinoline cross-links (nmolImmol-1 Cr)). Results: Retention in the 1-yr study was 84{\%} and median attendance to supervised classes was 84{\%} in POWIR and 74{\%} in FLEX. No study-related injuries were reported. There were no significant differences between groups for average L1-L4 BMD or for BMD at any hip site. When examining individual vertebrae, POWIR has a significant effect on preservation of BMD (j0.4{\%}) at the L4 vertebrae compared with losses (j3.1{\%}) in FLEX (P = 0.03). Conclusion: Impact + resistance training was a safe and acceptable form of exercise for older PCS on ADT. Among our limited sample, POWIR did not appear to have a clinically meaningful effect on hip or spine BMD, but some evidence of skeletal adaptation to resistance + impact training in an androgen-deprived state was apparent. Future studies need to be conducted on a larger sample of patients and should consider modifications to POWIR that could further enhance loading across the spine and at the hip to preserve BMD at these clinically relevant sites.",
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AU - Dobek, Jessica C.

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AU - Ryan, Christopher

AU - Beer, Tomasz (Tom)

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N2 - Introduction: Androgen deprivation therapy (ADT) is associated with significant bone loss and an increase in fracture risk among prostate cancer survivors (PCS). We investigated whether impact + resistance training could stop ADT-related declines in bone mineral density (BMD) among PCS on ADT. Methods: We randomized 51 PCS (mean age, 70.2 yr) currently prescribed ADT to participate in 1 yr of impact + resistance training (Prevent Osteoporosis with Impact + Resistance (POWIR)) or in an exercise placebo program of stretching exercise (FLEX). Outcomes were proximal femur (total hip, femoral neck, and greater trochanter) and spine (L1-L4) BMD (gIcm-2) and bone turnover markers (serum osteocalcin (ngImL-1) and urinary deoxypyrodinoline cross-links (nmolImmol-1 Cr)). Results: Retention in the 1-yr study was 84% and median attendance to supervised classes was 84% in POWIR and 74% in FLEX. No study-related injuries were reported. There were no significant differences between groups for average L1-L4 BMD or for BMD at any hip site. When examining individual vertebrae, POWIR has a significant effect on preservation of BMD (j0.4%) at the L4 vertebrae compared with losses (j3.1%) in FLEX (P = 0.03). Conclusion: Impact + resistance training was a safe and acceptable form of exercise for older PCS on ADT. Among our limited sample, POWIR did not appear to have a clinically meaningful effect on hip or spine BMD, but some evidence of skeletal adaptation to resistance + impact training in an androgen-deprived state was apparent. Future studies need to be conducted on a larger sample of patients and should consider modifications to POWIR that could further enhance loading across the spine and at the hip to preserve BMD at these clinically relevant sites.

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