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Exercise Prescription Dose for Castration Resistance Prostate Cancer Patients

Not Applicable
Completed
Conditions
Exercise
Prostatic Neoplasms
Physical Activity
Castration-resistant Prostate Cancer
Interventions
Behavioral: Exercise
Registration Number
NCT03526562
Lead Sponsor
University Hospital, Ghent
Brief Summary

Recent drug improvement (e.g. abiraterone or enzalutamide) for castration resistant prostate cancer (CRPC) patients has improved survival. As treatment strategies improve and patients live longer, patients must cope with their treatment-induced adverse effects. Improving levels of physical activity (PA) and less amounts of sitting time (e.g. sedentary behavior, SB) could have a positive impact on patient's health, non-cancer mortality, and quality of life and potentially improve survival.

The role of PA has not yet been examined in CRPC patients, which is a clear unmet need. No specific PA guidelines exist for CRPC patients, but specific guidelines are warranted because of advanced disease stage, reduced performance score and comorbidity. It is to be expected that the PA level of CRPC patients is lower compared to non-CRPC patients receiving androgen deprivation therapy (ADT).

This study aims to determine the optimal starting physical therapy prescription in CRPC patients receiving second line hormone treatment.

Detailed Description

CRPC patients receiving second-line hormone treatment at Ghent University Hospital are invited to participate in this phase I 3+3 dose escalation design (escalation to next exercise dose per 3 study patients). The prescription start dose is 15min. aerobic training (50-80% maximum heart rate (HRmax). warm-up and cooling-down and 65-80%HRmax. core), 1 set with 8-10 reps. resistance training (50-60% one repetition maximum (1RM), 8 exercises) and 1 set (30s.) with 2 reps. flexibility training (5 exercises). Factors determining compliance for the dose are tolerance and safety. Tolerance for the exercise prescription will be assessed with the Borg scale of perceived exertion after every exercise. Compliant for tolerance is a score ≤16. Safety will be assessed by the visual analogue scale (VAS) (assessed by the patient) for pain and the CTCAE criteria (assessed by a trained health care provider) for bone pain after every exercise. Compliant for safety is ≤3 VAS for exercise-induced pain and \<grade 2 according to the CTCAE criteria.

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
9
Inclusion Criteria
  • CRPC patients with second-line hormone treatment
  • Able to walk 400 meters without help from another person
  • Absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule (those conditions should be discussed with the patient before registration in the trial)
  • ≥4 weeks since any major surgery and fully recovered before patient registration
  • Written informed consent must be given according to International conference on harmonization Good Clinical Practice and national regulation.
Exclusion Criteria
  • Musculoskeletal, cardiovascular or neurological comorbidity that prevent the patient to participate in an exercise program
  • Painful bone metastases (VAS) at the time of inclusion
  • Unstable bone metastases (SINS classification) at time of inclusion

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Single arm phase I trial with 3 exercise dose-escalation armsExerciseexercise dose-escalation: aerobic, resistance and flexibility training
Primary Outcome Measures
NameTimeMethod
Maximum tolerated dose based on safetychange before and after 1 exercise session (at one day)

Maximum tolerated dose will be assessed by VAS

Maximum tolerated dose based on tolerancechange before and after 1 exercise session (at one day)

Maximum tolerated dose will be assessed by borg scale of perceived exertion.

Secondary Outcome Measures
NameTimeMethod
Physical activity level by International Physical Activity Questionnaire (IPAQ)baseline

Physical activity level will be assessed by the IPAQ questionnaire

Physical performancebaseline

Physical performance will be assessed by the 400m walk test

Body compositionbaseline

Body composition will be assessed by 8-point bioelectrical impedance analysis

Motivation 1baseline

Motivation will be assessed by the stages of change theory

Functionalitybaseline

Functionality will be assessed by the Karnofsky Performance Status

Health Related quality of Life generalbaseline

HRQoL will be assessed by the EORTC quality of life (QLQ) C30 questionnaire

Health Related quality of Life disease specificbaseline

HRQoL will be assessed by the EORTC quality of life prostate 25 questionnaire

Physical performance by 6 m walk backwardbaseline

Physical performance will be assessed by the 6 meter backward walk

Physical activity level by Godinbaseline

Physical activity level will be assessed by the Godin Leisure questionnaire

Physical performance by time up and gobaseline

Physical performance will be assessed by the time up and go test

Balance by four square testbaseline

Balance will be assessed by the four square test

Balance by chair rise testbaseline

Balance will be assessed by the chair rise test

Physical performance by 6m walkbaseline

Physical performance will be assessed by the 6-meter walk test usual and fast pace

Physical performance by Cardiopulmonary Exercise Testing (CPET)baseline

Physical performance will be assessed by the CPET

Motivation 2baseline

Motivation will be assessed by the Exercise Motivation Inventory questionnaire

Painbaseline

Pain will be assessed by the Brief pain inventory (BPI) questionnaire

Trial Locations

Locations (1)

University Hospital ghent

🇧🇪

Ghent, Oost-Vlaanderen, Belgium

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