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Effect of supervised and home exercise training on bone mineral density among breast cancer patients. A 12-month randomised controlled trial

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Abstract

Summary

The ability of combined step aerobic- and circuit-training to prevent bone loss after breast cancer treatments was related to skeletal site and patients’ menopausal status. Among premenopausal breast cancer survivors, a 12-month exercise intervention completely prevented bone loss at the femoral neck, whereas no exercise effect was seen at lumbar spine or at neither site in postmenopausal women.

Introduction

The primary objective of this randomised clinical trial was to determine the preventive effect of supervised weight-bearing jumping exercises and circuit training on bone loss among breast cancer patients.

Methods

Of 573 breast cancer survivors aged 35–68 years randomly allocated into exercise or control group after adjuvant treatments, 498 (87%) were included in the final analysis. The 12-month exercise intervention comprised weekly supervised step aerobic- and circuit-exercises and similar home training. Bone mineral density (BMD) at lumbar spine and femoral neck were measured by dual-energy X-ray absorptiometry. Physical performance was assessed by 2-km walking and figure-8 running tests, and the amount of physical activity was estimated in metabolic equivalent-hours/week.

Results

In premenopausal women, bone loss at the femoral neck was prevented by exercise, the mean BMD changes being −0.2% among the trainees vs. −1.4% among the controls (p = 0.01). Lumbar bone loss could not be prevented (−1.9% vs. −2.2%). In postmenopausal women, no significant exercise-effect on BMD was found either at the lumbar spine (−1.6% vs. −2.1%) or femoral neck (−1.1% vs. −1.1%).

Conclusions

This 12-month aerobic jumping and circuit training intervention completely prevented femoral neck bone loss in premenopausal breast cancer patients, whereas no effect on BMD was seen in postmenopausal women.

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Acknowledgements

The study has been financially supported by the Finnish Cancer Institute, the Finnish Cancer Foundation, the Academy of Finland, the Social Insurance Institution of Finland, The Finnish Ministry of Education, Finska Läkaresällskapet, the special government grant for health science research, the Helander Foundation, the Paulo Foundation, Finnish Cultural Foundation and Medical Fund of the Pirkanmaa Hospital District. Finnish Astra-Zeneca sponsored step benches for the study. The study is sponsored by the Finnish Breast Cancer group.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Oncology, Helsinki University Central Hospital, P.O. Box 180, Helsinki, 00029 HUS, Finland

    T. Saarto, L. Vehmanen, H. M. Penttinen, M. Utriainen, A. S. Jääskeläinen, A. Elme & C. Blomqvist

  2. The UKK Institute for Health Promotion Research, Tampere, Finland

    H. Sievänen, R. Nikander, M. Fogelholm & R. Luoto

  3. Department of Oncology, Tampere University Central Hospital, Tampere, Finland

    P. Kellokumpu-Lehtinen

  4. Department of Oncology, Turku University Central Hospital, Turku, Finland

    R. Huovinen & J. Ruohola

  5. Rehabilitation Unit, ORTON, Helsinki, Finland

    H. Kautiainen

  6. Unit of Family Practice, Central Finland Central Hospital, Jyväskylä, Finland

    H. Kautiainen

  7. The Medcare Foundation, Äänekoski, Finland

    S. Järvenpää

  8. Pirkanmaa Cancer Society, Tampere, Finland

    T. Palva

  9. Cancer Society of Finland, Helsinki, Finland

    H. Vertio & M. Rautalahti

  10. Finnish Academy, Helsinki, Finland

    M. Fogelholm

  11. National Institute for Health and Welfare, Helsinki, Finland

    R. Luoto

  12. Department of Welfare and Human Functioning, Helsinki Metropolia University of Applied Sciences, Helsinki, Finland

    R. Nikander

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  1. T. Saarto
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  2. H. Sievänen
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  19. C. Blomqvist
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Correspondence to T. Saarto.

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All authors have contributed to the study.

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Saarto, T., Sievänen, H., Kellokumpu-Lehtinen, P. et al. Effect of supervised and home exercise training on bone mineral density among breast cancer patients. A 12-month randomised controlled trial. Osteoporos Int 23, 1601–1612 (2012). https://doi.org/10.1007/s00198-011-1761-4

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  • DOI: https://doi.org/10.1007/s00198-011-1761-4

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