Improving Quality of Life during Androgen Deprivation Therapy in Prostate Adenocarcinoma Patients: Effect of Prescribed Clinic-Based Exercise Program

Context: The mainstay of treatment of advanced prostate adenocarcinoma is androgen deprivation therapy (ADT). ADT invariably results in a progressive loss of bone density and muscle mass and diminishing cardiopulmonary and cognitive function. Exercise is beneficial as adjuvant treatment during ADT. Aim: This study seeks to identify the benefit of prescribed exercise programs beyond routine physical activities of daily living in low‑income patients on ADT. Settings and Design: Men on ADT for 12 months who were in the remission phase of the disease were recruited for a 6 week supervised aerobic and resistive exercise program. Subjects and Methods: The effects of the prescribed exercise on muscle strength (MS), peak expiratory flow rate ( PEFR), maximum  oxygen uptake (MOU) and brief fatigue inventory (BFI) were assessed. 10R max test was deployed for MS while the modified Young Men Christian Association protocol for bicycle ergometer was used for PEFR and MOU. All measures were taken pre‑ and post‑intervention with a check for adverse events at week 3. Statistical Analysis Used: Simple frequency in SPSS version 21 was used. Results: Only 5 of 34 recruited subjects completed the study. There was 34.0% improvement in MOU, 34.9% improvement in PEFR, 130.0% increase in exercise duration, and 29.2% reduction in reported BFI. Improvement in parameters was more among those that had lower values at recruitment. Compliance with exercise prescription was a major challenge. All participants reported improvement in activities of daily living. Conclusions: Prescribed aerobic and resistive exercise program is beneficial during ADT for prostate adenocarcinoma. Those with poorer reserves tend to benefit more. Keywords: Androgen deprivation therapy, muscle strength, peak exploratory flow rate, prescribed exercise, prostate adenocarcinom

Psychotherapieforschung

These guidelines address the diagnosis and management of atherosclerotic, aneurysmal, and thromboembolic peripheral arterial diseases (PADs). The clinical manifestations of PAD are a major cause of acute and chronic illness, are associated with decrements in functional capacity and quality of life, cause limb amputation, and increase the risk of death. Whereas the term “peripheral arterial disease” encompasses a large series of disorders that affect arterial beds exclusive of the coronary arteries, this writing committee chose to limit the scope of the work of this document to include the disorders of the abdominal aorta, renal and mesenteric arteries, and lower extremity arteries. The purposes of the full guidelines are to (a) aid in the recognition, diagnosis, and treatment of PAD of the aorta and lower extremities, addressing its prevalence, impact on quality of life, cardiovascular ischemic risk, and risk of critical limb ischemia (CLI); (b) aid in the recognition, diagnosis, and treatment of renal and visceral arterial diseases; and (c) improve the detection and treatment of abdominal and branch artery aneurysms. Clinical management guidelines for other arterial beds (e.g., the thoracic aorta, carotid and vertebral arteries, and upper-extremity arteries) have been excluded from the current guidelines to focus on the infradiaphragmatic arterial system and in recognition of the robust evidence base that exists for the aortic, visceral, and lower extremity arteries