BACKGROUND: The current study examined effects, moderators (for whom), and mediators (working mechanisms) of 12 months of exercise on health-related quality of life (HRQoL) in older long-term survivors of prostate cancer.
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METHODS: In total, 100 men aged 71.7 years (standard deviation, 6.4 years) were randomly assigned to 6 months of supervised aerobic and resistance exercise followed by 6 months of a home-based exercise maintenance program (EX group) or printed education material regarding physical activity for 12 months (PA group). Assessments took place at baseline and after 6 and 12 months. Generalized estimating equations were used to study the effects of EX versus PA on HRQoL at 6 and 12 months, adjusting for baseline HRQoL. The authors examined potential sociodemographic and clinical moderators by adding interaction terms, and potential physical and psychological mediators using the product-of-coefficients test.
RESULTS: At 6 months, significant beneficial effects were found for global QoL, physical function, and social function in the EX group compared with the PA group. For physical function, beneficial effects were sustained at 12 months. Moderation analyses demonstrated larger effects of EX versus PA for patients who were married, started exercising sooner after their diagnosis, and previously used bisphosphonates. Changes in lower body functional performance significantly mediated the effect of EX on global QoL, physical function, and social function. No mediating effects on HRQoL were found for aerobic fitness, physical activity, fatigue, distress, or falls self-efficacy.
CONCLUSIONS: Aerobic and resistance exercise appears to have beneficial effects on HRQoL among older, long-term survivors of prostate cancer. Effects were moderated by marital status, time since diagnosis, and use of bisphosphonates, and were mediated by lower body functional performance.
Buffart LM, Newton RU, Chinapaw MJ, Taaffe DR2,, Spry NA, Denham JW7, Joseph DJ, Lamb DS, Brug J, Galvão DA. Are you the author?
Department of Epidemiology and Biostatistics, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands; Edith Cowan University Health and Wellness Institute, Edith Cowan University, Joondalup, Western Australia, Australia; Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands; School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia; Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; Faculty of Medicine, University of Western Australia, Nedlands, Western Australia, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Newcastle Mater Hospital, Newcastle, New South Wales, Australia; Department of Surgery, University of Western Australia, Nedlands, Western Australia, Australia; Department of Pathology and Molecular Medicine, University of Otago, Wellington, New Zealand.
Reference: Cancer. 2015 Apr 17. Epub ahead of print.