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

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. [ABSTRACT FROM AUTHOR]