Summary

A 12-month exercise program reversibly prevented hip bone loss in premenopausal women with early breast cancer. The bone-protective effect was maintained for 2 years after the end of the program but was lost thereafter.

Purpose

Breast cancer survivors are at an increased risk for osteoporosis and fracture. This 5-year follow-up of a randomized impact exercise intervention trial evaluated the maintenance of training effects on bone among breast cancer patients.

Methods

Five hundred seventy-three early breast cancer patients aged 35–68 years and treated with adjuvant therapy were allocated into a 12-month exercise program or a control group. Four hundred forty-four patients (77%) were included in the 5-year analysis. The exercise intervention comprised weekly supervised step aerobics, circuit exercises, and home training. Areal bone mineral density (aBMD) was measured by dual-energy X-ray absorptiometry. Physical activity was estimated in metabolic equivalent (MET) hours per week and physical performance assessed by 2-km walking and figure-8 running tests.

Results

In premenopausal patients, the 12-month exercise program maintained femoral neck (FN) and total hip (TH) aBMD for 3 years, but the protective effect was lost thereafter. The mean FN aBMD change in the exercise and control groups was − 0.2% and − 1.5% 1 year, − 1.1% and − 2.1% 3 years and − 3.3% versus − 2.4% 5 years after the beginning of the intervention, respectively. Lumbar spine (LS) bone loss was not prevented in premenopausal women and no training effects on aBMD were seen in postmenopausal women. The main confounding element of the study was the unexpected rise in physical activity among patients in the control group. The physical performance improved among premenopausal women in the exercise group compared with the controls.

Conclusion

The 12-month exercise program prevented FN and TH bone loss in premenopausal breast cancer patients for 3 years. The bone-protective effect was reversible and lost thereafter.

中文翻译：

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有氧和冲击训练对早期乳腺癌患者骨密度的五年随访结果。

概括

一项为期 12 个月的锻炼计划可逆地防止了患有早期乳腺癌的绝经前妇女的髋骨丢失。骨保护效果在计划结束后保持了 2 年，但此后就消失了。

目的

乳腺癌幸存者患骨质疏松症和骨折的风险增加。这项随机冲击运动干预试验的 5 年随访评估了乳腺癌患者维持训练对骨骼的影响。

方法

573 名年龄在 35-68 岁并接受辅助治疗的早期乳腺癌患者被分配到 12 个月的锻炼计划或对照组。444 名患者 (77%) 包括在 5 年分析中。运动干预包括每周有监督的有氧运动、循环运动和家庭训练。通过双能 X 射线吸收法测量面骨矿物质密度 (aBMD)。身体活动以每周代谢当量 (MET) 小时为单位进行评估，身体表现通过 2 公里步行和数字 8 跑步测试进行评估。

结果

在绝经前患者中，12 个月的锻炼计划维持了股骨颈 (FN) 和全髋关节 (TH) aBMD 3 年，但此后保护作用消失。在干预开始后，运动组和对照组的平均 FN aBMD 变化分别为 - 0.2% 和 - 1.5% 1 年， - 1.1% 和 - 2.1% 3 年以及 - 3.3% 和 - 2.4%。绝经前妇女的腰椎 (LS) 骨质流失并未得到预防，并且在绝经后妇女中未观察到训练对 aBMD 的影响。该研究的主要混杂因素是对照组患者身体活动的意外增加。与对照组相比，运动组绝经前妇女的身体机能有所改善。

结论

为期 12 个月的锻炼计划在 3 年内防止了绝经前乳腺癌患者的 FN 和 TH 骨质流失。骨保护作用是可逆的，此后就消失了。