BACKGROUND Androgen deprivation therapy (ADT) in men with prostate cancer (PCa) results in adverse effects, including reduced muscle strength and physical function, potentially compromising daily functioning. We examined whether it was more efficacious to commence exercise at the onset of ADT rather than later in treatment to counter declines in strength and physical function. METHODS One-hundred-and-four men with PCa (68.3 ± 7.0 years) initiating ADT were randomised to immediate exercise (IMX, n = 54) or delayed exercise (DEL, n = 50) for 12 months. IMX comprised 6 months of supervised resistance/aerobic/impact exercise initiated at the onset of ADT with a 6-month follow-up. DEL comprised 6 months of usual care followed by 6 months of resistance/aerobic/impact exercise. Upper and lower body muscle strength and physical function were assessed at baseline, 6 and 12 months. RESULTS There was a significant difference for all strength measures at 6 months favouring IMX (P < 0.001), with net differences in leg press, seated row and chest press strength of 19.9 kg (95% CI, 12.3-27.5 kg), 5.6 kg (3.8-7.4 kg) and 4.3 kg (2.7-5.8 kg), respectively. From 7 to 12 months, DEL increased in all strength measures (P < 0.001), with no differences between groups at 12 months. Similarly, physical function improved (P < 0.001) in IMX compared with DEL at 6 months for the 6-m fast walk (-0.2, 95% CI -0.3 to -0.1 s), 400-m walk (-9.7, -14.8 to -4.6 s), stair climb (-0.4, -0.6 to -0.2 s) and chair rise (-1.0, -1.4 to -0.7 s), with no differences between groups by 12 months, except for the 6-m fast walk (P < 0.001). CONCLUSION Exercise either at the onset or after 6 months of ADT preserves/enhances muscle strength and physical function. However, to avoid initial treatment-related adverse effects on strength and function, exercise therapy should be implemented with initiation of ADT.

中文翻译：

---

男性开始进行ADT前列腺癌运动时，其肌肉力量和身体机能的锻炼时间。

背景技术雄激素剥夺疗法（ADT）在患有前列腺癌（PCa）的男性中导致不良反应，包括降低的肌肉力量和身体功能，潜在地损害日常功能。我们检查了在ADT发作时开始锻炼比在以后的治疗中对抗力量和身体机能下降是否更有效。方法144例PCa（68.3±7.0岁）开始ADT的男性患者随机接受即刻锻炼（IMX，n = 54）或延迟锻炼（DEL，n = 50），为期12个月。IMX包括ADT发作时开始的6个月有监督的抵抗/有氧/冲击运动，并进行6个月的随访。DEL包括6个月的常规护理，然后是6个月的抗性/有氧运动/冲击运动。在基线，6个月和12个月时评估上，下身的肌肉力量和身体功能。结果6个月后，所有强度测量结果均优于IMX（P <0.001），腿部按压，坐姿行和胸部按压强度的净差异为19.9 kg（95％CI，12.3-27.5 kg），5.6 kg （3.8-7.4公斤）和4.3公斤（2.7-5.8公斤）。从7个月到12个月，所有强度指标的DEL均升高（P <0.001），两组之间在12个月时无差异。同样，在6个月的快步行走（-0.2，95％CI -0.3至-0.1 s），400步长的步行（-9.7，-14.8）下，与6个月的DEL相比，IMX的身体功能得到改善（P <0.001）到-4.6 s），爬楼梯（-0.4，-0.6到-0.2 s）和椅子上升（-1.0，-1.4到-0.7 s），各组之间在12个月内没有差异，除了6米快速行走（P <0.001）。结论运动可以在ADT开始时或6个月后保持/增强肌肉力量和身体机能。但是，为了避免与强度和功能相关的初始治疗相关不良影响，应在开始ADT的同时进行运动疗法。