Table 1 Study characteristics of the five included RCTs

Alberga et al. 2012

Canada [99]

Histologically documented prostate cancer; scheduled to receive radiotherapy with or without ADT; consent of treating oncologist (Note: this article reported a subgroup analysis limited to patients on ADT)

Severe cardiac disease (New York Heart Association class III or IV); uncontrolled hypertension, pain, psychiatric illness; residence > 1 h from the study center.

N = 49

66 year

PRT supervised by a certified fitness consultant, 3 sessions/week, 24 weeks. Ten exercises (i.e. leg extension, leg curl, seated chest fly, latissimus pulldown, overhead press, triceps extension, biceps curls, calf raises, low back extension, and modified curl-ups) using 60-70% 1RM load, 8-12 reps per set, 2 sets per exercise. Load increased by 5lb (2.3kg) when able to complete > 12 reps/set.

Usual care (no exercise)

24

Nilsen et al. 2015, 2016

Norway [100, 104]

Intermediate or high-risk profile based on PSA and histology and extent of the primary tumour; referred to high-dose radiotherapy 2–6 months after initiation of neo-adjuvant ADT; adjuvant ADT continuing for 9-36 mo.; age ≤75 years;

Strength training ≥ 1 session/week; osteoporosis medication usage; medical conditions that could complicate participation

N = 58

66y

Two supervised (high intensity) plus one unsupervised (moderate intensity) PRT session/wk, 16 weeks. Nine exercises (i.e. Smith machine half squat, leg press, Smith machine standing calf raises, knee flexion, knee extension, chest press, seated row, seated shoulder press, and biceps curl), 1–3 sets/exercise, 6–10 RM, loading increased with strength adaptation

Usual care (no exercise)

16

Segal et al. 2003

Canada [101]

Histologically documented prostate cancer; scheduled to receive >3mo. ADT; consent of treating oncologist

Severe cardiac disease (New York Heart Association class III or IV); uncontrolled hypertension (> 160/95 mmHg); uncontrolled pain; unstable bone lesions; residence > 1 h from the study center.

N = 135

68y

PRT supervised by a certified fitness consultant, 3 sessions/week, 12 weeks. Nine exercises (i.e. leg extension, calf raises, leg curl, chest press, lat pulldown, overhead press, triceps extension, biceps curls, and modified curl-ups) using 60–70% 1RM load, 8–12 reps per set, 2 sets per exercise. Load increased by 5 lb (2.3 kg) when able to complete > 12 reps/set.

Usual care (no exercise)

12

Taafe et al. 2017

Australia [102]

Histologically confirmed prostate cancer; > 2-month exposure to and anticipated to receive 12 months additional ADT; without PSA evidence of disease activity; medical clearance

Bone metastatic disease; evidence of PSA disease activity; chronic conditions that could inhibit exercising; non-ambulatory; structured exercise in the previous 3 months;

N = 105

68 year

Two supervised PRT group-based sessions (n < 10), 2 sessions/week, 52 weeks. Impact-loading: bounding, skipping, drop jumping, hopping, and leaping activities that produced ground reaction forces of 3.4–5.2 times body weight and progressive in nature. Resistance training: six principal exercises (i.e. chest press, seated row, shoulder press, leg press, leg extension, and leg curl) and supplementary exercises, 2–4 sets per exercise at an intensity of 6–12 RM. Participants also performed impact loading routine 2 sessions/week at home.

Usual care (no exercise)

52

Winters-Stone et al. 2014, 2015

USA [105]

Histologic evidence of prostate cancer; currently receiving ADT; BMD T-score − 2.5 or higher; medical clearance from physician

Currently receiving chemotherapy; bone metastases in the hip or spine, bone-active medications other than ADT (e.g., bisphosphonates); participation in 30 min or more of moderate–vigorous PRT per week

N = 51

70 year

Two supervised plus one home-based PRT session/week, 52 weeks. PRT exercises (i.e. wall-sits, squats, bent-knee deadlifts, lunges, one-arm row, chest press, lateral raise, and push-ups) and impact loading (i.e. two-footed jump) using free weights or weighted vest. PRT performed for 1–2 sets x 6–14 reps/exercise. Jumping progressed from 1–10 sets x 10 reps. All loading progressed with strength gains.

Placebo control (stretching and relaxation)

52