Strength training stops bone loss and builds muscle in postmenopausal breast cancer survivors: a randomized, controlled trial

  • Kerri M. Winters-Stone
  • Jessica Dobek
  • Lillian Nail
  • Jill A. Bennett
  • Michael C. Leo
  • Arpana Naik
  • Anna Schwartz
Clinical trial

Abstract

Targeted exercise training could reduce risk factors for fracture and obesity-related diseases that increase from breast cancer treatment, but has not been sufficiently tested. We hypothesized that progressive, moderate-intensity resistance + impact training would increase or maintain hip and spine bone mass, lean mass and fat mass and reduce bone turnover compared to controls who participated in a low-intensity, non-weight bearing stretching program. We conducted a randomized, controlled trial in 106 women with early stage breast cancer who were >1 year post-radiation and/or chemotherapy, ≥50 years of age at diagnosis and postmenopausal, free from osteoporosis and medications for bone loss, resistance and impact exercise naïve, and cleared to exercise by a physician. Women were randomly assigned to participate in 1 year of thrice-weekly progressive, moderate-intensity resistance + impact (jump) exercise or in a similar frequency and length control program of progressive, low-intensity stretching. Primary endpoints were bone mineral density (BMD; g/cm2) of the hip and spine and whole body bone-free lean and fat mass (kg) determined by DXA and biomarkers of bone turnover—serum osteocalcin (ng/ml) and urinary deoxypyrodiniline cross-links (nmol/mmolCr). Women in the resistance + impact training program preserved BMD at the lumbar spine (0.47 vs. −2.13%; P = 0.001) compared to controls. The resistance + impact group had a smaller increase in osteocalcin (7.0 vs. 27%, P = 0.03) and a larger decrease in deoxypyrodinoline (−49.9 vs. −32.6%, P = 0.06) than controls. Increases in lean mass from resistance + impact training were greatest among women currently taking aromatase inhibitors compared to controls not on this therapy (P = 0.01). Our combined program of resistance + impact exercise reduced risk factors for fracture among postmenopausal breast cancer survivors (BCS) and may be particularly relevant for BCS on aromatase inhibitors (AIs) because of the additional benefit of exercise on muscle mass that could reduce falls.

Keywords

Osteoporosis Resistance exercise Body composition Neoplasms Aromatase inhibitors 

Notes

Acknowledgments

Supported by Susan G. Komen for the Cure and the National Cancer Institute (1R01 CA120123, to Dr. Winters-Stone) and with partial support from the Oregon Clinical and Translational Research Institute (OCTRI), Grant number UL1 RR024140 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. We thank the Oregon State Cancer Registry for their assistance with recruitment efforts for the study. Thera-band provided elastic bands for home exercise programs. We thank Ms. Ann Reiner for helping to manage the study and Mr. Nathan Brooks, Ms. Camella Potter, and Mr. Anton Stupnitskiy for their assistance with data collection. We also thank Ms. Janice Hoffman, Ms. Laurie Iverson, and Ms. Lisa Domenico for their assistance with exercise training.

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Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  • Kerri M. Winters-Stone
    • 1
  • Jessica Dobek
    • 1
  • Lillian Nail
    • 1
  • Jill A. Bennett
    • 1
  • Michael C. Leo
    • 1
  • Arpana Naik
    • 2
  • Anna Schwartz
    • 3
  1. 1.School of NursingOregon Health & Science UniversityPortlandUSA
  2. 2.School of MedicineOregon Health & Science UniversityPortlandUSA
  3. 3.School of NursingUniversity of WashingtonSeattleUSA

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