Novel physical activity interventions for older patients with prostate cancer on hormone therapy: A pilot randomized study

Background: Androgen deprivation therapy (ADT) can decrease the physical performance (PP) of older men with prostate cancer (PC). Methods: We conducted a three-arm randomized pilot study (n = 19) comparing a home-based walking and resistance intervention (EXCAP) and a technology-mediated walking and resistance intervention using Wii-Fit to a usual-care arm in men >= 70 years with PC receiving ADT. The intervention lasted for 6 weeks, with follow-up at 12 weeks. The primary pre-specified outcome was change in Short Physical Performance Battery (SPPB) score. Mixed effects regression models were used to assess change in outcomes over time. Results: Mean participant age was 70 years (range: 67-93). Eight patients were randomized to the Wii-Fit arm, 6 to the EXCAP arm, and 5 to the usual-care arm. SPPB scores remained nearly constant in the usual-care arm (beta = 0.12; p = 0.79), while individuals in the EXCAP arm had on average a 1.2 point increase at each follow-up (beta = 1.20; 95% CI: 0.36, 2.06). The Wii-fit arm had a non-significant increase in SPPB score over time relative to usual-care (beta = 0.32; 95% CI 0.43, 1.06; p = 0.46). Individuals in the EXCAP arm had an increase in steps per day over time compared to the usual-care arm (p-value = 0.006); the EXCAP arm had an increase of 2720 steps (95% CI: 1313, 4128) while the usual-care arm had an increase of 97 steps (95% CI:-1140, 1333). Participants in the Wii-Fit arm had an increase of 1020 steps (95% CI:-474, 1238, p = 0.710). Other outcomes (i.e., handgrip strength, lean muscle mass, and chest press repetitions) were not statistically significant. Conclusions: A home-based aerobic and resistance exercise program, EXCAP, shows promise for improving PP in older men with PC on ADT. (C) 2016 Elsevier Ltd. All rights reserved.