Objective/Purpose:
Prostate cancer (PCa) patients who undergo surgery to recover from prostate cancer and improve their quality of life can choose from multiple exercise treatments. There have been a few studies showing the effects of exercise on prostate cancer patients' quality of life, but none have compared the effects of different exercise therapies.
This study compared the effectiveness of different exercise therapies (aerobic, resistance, pelvic floor muscle exercise [PFME], mind-body, and combination therapy) on health-related quality of life (HRQoL), postoperative adverse events, and mortality in prostate cancer (PCa) patients undergoing surgery.
Sample and Setting: A network meta-analysis was conducted using 15 eligible randomized controlled trials (RCTs) from PubMed, Web of Science, SPORTSDiscus, and Cochrane Library (inception to 30 March 2020), involving 1,971 participants. Interventions included PFME (n = 917), biofeedback (n = 35), aerobic (n = 2), resistance (n = 1), and mixed exercise (n = 1).
Procedures: Eligible studies assessed HRQoL using validated measures or recorded adverse events (e.g., Clavien-Dindo criteria). Direct and indirect comparisons were performed to evaluate the efficacy of different exercise therapies.
Results: PFME demonstrated the greatest improvement in HRQoL compared to control groups and other exercise interventions (aerobic, resistance, mind-body, and combination therapy). Limited evidence was available for other exercise modalities, with fewer studies assessing their impact. Adverse event rates and mortality data were insufficient for conclusive comparisons.
Conclusion and Clinical Implications: PFME appears to be the most effective exercise therapy for enhancing HRQoL in PCa patients post-surgery and should be integrated into rehabilitation programs. Further high-quality RCTs are needed to evaluate the comparative benefits of other exercise types, particularly regarding long-term outcomes and adverse events. Clinicians should prioritize PFME while considering patient preferences and feasibility when designing postoperative exercise regimens.