A Pilot Feasibility Study of Exercising Together© During Radiation Therapy for Prostate Cancer: A Dyadic Approach for Patients and Spouses
Abstract Introduction: Prostate cancer can negatively impact the health of patients and their spouse, particularly early on in the cancer trajectory. Purpose: To determine the feasibility and acceptability of dyadic exercise during radiation therapy and preliminary efficacy on physical, mental and relational outcomes for men and their spouses. Exercising Together©, originally designed as a 6-month dyadic resistance training program for couples post-treatment, was adapted for the radiation setting.Methods: We conducted a single-group pilot feasibility study of Exercising Together© in men scheduled for radiation therapy for prostate cancer and their spouse. Couples attended supervised exercise sessions thrice weekly throughout radiation treatment and were followed-up 8 weeks later. Primary outcomes were feasibility and acceptability with secondary outcomes of changes in physical (physical functioning (short physical performance battery (SPPB)), gait speed (m/sec), functional capacity (400-meter walk (min), physical activity (min/week)), mental (depressive symptoms (CES-D) and anxiety (SCL-90 ANX)), and relationship (Dyadic Coping, Role Overload and Physical Intimacy Behavior Scales) health outcomes for each partner. Participants completed an evaluation post-intervention.Results: Ten couples enrolled and 8 completed the intervention, attending 83% of scheduled sessions. Couple satisfaction with the intervention was high (patients: x̄=9.4±1.9 and spouses: x̄=10.0±0.0, on a 1-10 scale). At post-intervention, gait speed (x̄=0.1; 95%CI: 0.1, 0.2; p=0.003; d=0.94) and functional capacity (x̄=-0.6; 95%CI: -0.9, 0.3; p=0.002; d=-0.42) improved in patients and SPPB in spouses (x̄=1.3; 95%CI: 0.3, 2.2; p=0.02; d=0.71). Total physical activity increased non-significantly for patients and significantly for spouses at post-intervention and decreased at follow-up (x̄=179.6; 95%CI: 55.4, 303.7; p=0.01; d=1.35 and x̄=-139.9; 95%CI: -266.5,13.3; p=0.03; d=1.06). Among patients, anxiety and active engagement significantly improved post-intervention (x̄=-2.3; 95%CI: -3.8, 0.7; p=0.01; d=-0.43 and x̄=2.5; 95%CI: 0.7, 4.3; p=0.01; d=0.98, respectively). There were modest effects on other physical, mental, and relationship health domains in patients and spouses.Conclusion: A modified version of Exercising Together© is a feasible and acceptable program during radiation therapy for prostate cancer and shows preliminary evidence for improvements on physical, mental, and relational health in both patient and spouse. A larger, fully powered randomized controlled trial is warranted and could help shift the landscape toward dyadically-targeted interventions.Trial Registration: This study was registered on ClinicalTrials.gov on February 18th, 2018 (NCT03418025; https://clinicaltrials.gov/ct2/show/NCT03418025).