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. 2012 Aug 15;2012(8):CD008465. doi: 10.1002/14651858.CD008465.pub2

Segal 2009.

Study characteristics
Methods Study design: RCT
Number randomized: 121; 40 to the aerobic exercise group, 40 to the resistance training exercise group, and 41 to the control group
Study start and stop dates: February 2003 to April 2006
Length of intervention: 24 weeks
Length of follow‐up: to end of the intervention
Participants Type cancer: prostate cancer
Stage, n (%):

  • aerobic exercise group: Stage I, 1 (2.5%); Stage II, 29 (72.5%); Stage III, 9 (22.5%); Stage IV, 0 (0%); unassignable, 1 (2.5%)

  • resistance exercise group: Stage I, 0 (0%); Stage II, 31 (77.5%); Stage III, 8 (20.0%); Stage IV, 8 (20.0%); unassignable, 1 (2.5%)

  • control group: Stage I, 0 (%); Stage II, 35 (85.4%); Stage III, 4 (9.8%); Stage IV, 1 (2.4%); unassignable, 1 (2.4%)


Time since cancer diagnosis: not reported
Time in active treatment: not reported
Inclusion criteria:

  • histologically documented prostate cancer

  • scheduled to receive radiation therapy with or without androgen deprivation therapy

  • treating oncologist approved


Eligibility criteria related to interest or ability, or both, to exercise:

  • none


Exclusion criteria:

  • severe cardiac disease (NYHA functional class III or IV)

  • uncontrolled hypertension

  • uncontrolled pain

  • psychiatric illness

  • lives > 1 hour away


Gender: male
Current age, mean (SD) years:

  • aerobic exercise group: 66.2 (6.8) years

  • resistance exercise group: 66.4 (7.6) years

  • control group: 65.3 (7.6) years


Age at cancer diagnosis: not reported
Ethnicity/race: not reported
Education level; completed university or college, n (%):

  • aerobic exercise group: 22 (55%)

  • resistance exercise group: 19 (47.5%)  

  • control group: 21 (51.2%)


SES: not reported
Employment status; employed full‐time, n (%):

  • aerobic exercise group: 9 (22.5%)

  • resistance exercise group: 6 (15.0%)

  • control group: 14 (34.1%)


Comorbidities: no reported
Past exercise history: not reported
On hormone therapy: not reported
Weight, mean (SD) kg:

  • aerobic exercise group: 88.1 (10.9) kg

  • resistance exercise group: 84.3 (9.9) kg

  • control group: 86.5 (15.2) kg


BMI, mean (SD):

  • aerobic exercise group: 28.9 (3.4)

  • resistance exercise group: 28.1 (3.5)

  • control group: 29.0 (4.2)
Interventions 40 participants assigned to the aerobic exercise intervention, including:

  • exercise on a cycle ergometer, treadmill, or elliptical trainer


40 participants assigned to the resistance exercise intervention, including:

  • 2 sets of 8 to 12 repetitions of 10 different exercises (leg extension, leg curl, seated chest fly, latissimus pull‐down, overhead press, triceps extension, biceps curls, calf raises, low back extension, and modified curl‐ups)


Type exercise (aerobic/anaerobic): aerobic or anaerobic
Intensity of the aerobic exercise intervention: beginning at 50% to 60% of their predetermined peak oxygen consumption (VO2peak) for weeks 1 to 4 and progressing to 70% to 75% for weeks 5 to 24
Intensity of anaerobic exercise intervention: 60% to 70% of estimated 1‐repetition maximum, increased by 5 lb when more than 12 repetitions
Frequency: 3 times per week
Duration of individual sessions: initially 15 minutes, increasing by 5 minutes every 3 weeks up to 45 minutes
Duration of exercise program: 24 weeks
Total number of exercise sessions: 72 sessions
Format: individual
Facility: facility
Professionally led: professionally led by an exercise specialist
Adherence: resistance and aerobic participants completed a median of 88% (63 of 72 sessions) and 83% (60 of 72 sessions) of scheduled sessions, respectively
41 participants assigned to control group, including:

  • request not to initiate exercise

  • offer of a program postintervention assessments and radiation therapy


Contamination of control group: 6 control participants reported aerobic exercise ≥ 3 times per week
Outcomes Outcome included HRQoL outcomes of:

  • fatigue, assessed using the FACT‐F

  • prostate‐specific QoL, assessed using the FACT‐P

  • general cancer‐specific QoL were assessed using the FACT‐G


Physical outcomes, including:

  • aerobic fitness,

  • strength

  • body weight

  • body fat percentage,

  • serum lipids

  • PSA

  • testosterone

  • hemoglobin


Outcomes were measured at baseline, 12 weeks, and 24 weeks:

  • aerobic exercise group: n = 40 at baseline, n = 35 for fatigue at 12 weeks, n = 34 at 24 weeks

  • resistance exercise group: n = 40 at baseline, n = 39 for fatigue at 12 weeks, n = 38 at 24 weeks

  • control group: n = 41 at baseline, n = 38 at 12 weeks, n = 39 at 24 weeks


Adverse events: 1 myocardial infarction, 1 syncope in aerobic group, 1 chest pain in resistance group
Notes Country: Canada
Funding: Canadian Prostate Cancer Research Fund
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Computer generated
Allocation concealment (selection bias) Low risk "Central random assignment was used, with allocation concealment before assignment"
Blinding of participants and personnel (performance bias)
All outcomes High risk Owing to the nature of the intervention, it was not possible to conceal allocation to the intervention from the participants
Blinding of outcome assessment (detection bias)
All outcomes High risk Study personnel and outcome assessors were not masked or blinded to the study interventions
Incomplete outcome data (attrition bias)
All outcomes Low risk Used mixed model, analyzing data from all participants, 7 withdrew in aerobic exercise group, 3 withdrew in resistance group, and 1 withdrew in control group
Selective reporting (reporting bias) Low risk There appears to be no selective reporting of outcomes
Other bias Low risk The trial appears to be free of other problems that could put it at a high risk of bias