Exercise Adherence in Men with Prostate Cancer Undergoing Androgen Deprivation Therapy: A Systematic Review and Meta-Analysis

SIMPLE SUMMARY: Prostate cancer treatments, including androgen deprivation therapy, can lead to a range of undesirable physical and psychological alterations for men. Participating in regular exercise has been shown to reduce the severity of these changes, providing an opportunity to improve the lives of these patients. There are a range of exercise interventions described in the literature; however, it is unknown what the optimal type of exercise to encourage adherence is. This systematic review and meta-analysis investigates exercise intervention adherence of patients receiving androgen deprivation therapy while identifying some of the effects of exercise on some physiological outcomes. It also includes a qualitative perspective to describe the issues relating to exercise for this population in both real-life and intervention settings. This research is vital, as future research may benefit from the understanding of the factors that will encourage exercise participation in this population. ABSTRACT: Androgen deprivation therapy (ADT) for prostate cancer treatment is associated with adverse physiological changes; however, exercise can improve outcomes. This systematic review and meta-analysis aimed to determine exercise intervention adherence and its effects on physiological outcomes in men diagnosed with prostate cancer undergoing ADT. Uniquely, this review incorporated a meta-aggregation of qualitative data, providing perspectives from the men’s experiences. A systematic review and meta-analysis were completed following PRISMA guidelines. Databases (CINAHL, Cochrane, PubMed) were searched for studies using “prostate cancer”, “exercise intervention”, and “androgen deprivation therapy”. Quantitative randomised controlled trials describing adherence to exercise interventions were selected, with qualitative articles selected based on descriptions of experiences around participation. Subgroup meta-analyses of adherence, exercise mode, and intervention duration were completed for quality of life, aerobic fitness, fatigue, and strength. In total, 644 articles were identified, with 29 (n = 23 quantitative; n = 6 qualitative) articles from 25 studies included. Exercise had no effects (p < 0.05) on quality of life and fatigue. Significant effects (all p < 0.05) were observed for aerobic fitness, and upper- and lower-body strength. Adherence to exercise-based interventions was 80.38%, with improvements observed in aerobic fitness and strength. Subgroup analysis revealed exercise adherence impacted fatigue and strength, with greater improvements observed in programs >12-weeks.