Aerobic and resistance exercise improves physical fitness, bone health, and quality of life in overweight and obese breast cancer survivors: a randomized controlled trial

Christina M Dieli-Conwright; Kerry S Courneya; Wendy Demark-Wahnefried; Nathalie Sami; Kyuwan Lee; Frank C Sweeney; Christina Stewart; Thomas A Buchanan; Darcy Spicer; Debu Tripathy; Leslie Bernstein; Joanne E Mortimer

doi:10.1186/s13058-018-1051-6

Table 2 Comparison of bone health between exercise and usual care groups

From: Aerobic and resistance exercise improves physical fitness, bone health, and quality of life in overweight and obese breast cancer survivors: a randomized controlled trial

	Baseline	Post-intervention		3-month follow-up		Between-group difference post-intervention
	Mean (SD)	Mean (SD)	P value^a	Mean (SD)	P value^b	Mean (95% CI)	P value^c
Calcium (mg/dL)
Exercise	10.3 (2.6)	13.7 (1.9)	0.09	13.4 (1.7)	0.10	3.4 (5.0 to 1.6)	0.10
Usual care	10.5 (2.5)	9.9 (2.6)	0.67	–	–	3.4 (5.0 to 1.6)	0.10
25(OH)D (ng/dL)
Exercise	21.7 (4.4)	27.8 (6.7)	0.09	27.4 (6.5)	0.09	6.1 (9.8 to 4.3)	0.10
Usual care	21.5 (4.1)	20.9 (4.0)	0.57	–	–	6.1 (9.8 to 4.3)	0.10
Osteocalcin (ng/mL)
Exercise	12.1 (3.1)	15.0 (4.1)	0.01	14.7 (3.5)	0.01	3.1 (5.6 to 1.5)	0.01
Usual care	12.3 (3.4)	12.0 (3.0)	0.61	–	–	3.1 (5.6 to 1.5)	0.01
BSAP (ng/mL)
Exercise	16.1 (4.6)	18.0 (5.0)	0.01	17.7 (4.6)	0.01	1.9 (2.4 to 0.55)	0.001
Usual care	16.2 (4.3)	15.9 (4.2)	0.55	–	–	1.9 (2.4 to 0.55)	0.001
CTX (ng/mL)
Exercise	0.48 (0.1)	0.44 (0.2)	0.07	0.44 (0.2)	0.07	−0.04 (−0.10 to −0.06)	0.10
Usual care	0.47 (0.1)	0.48 (0.2)	0.74	–	–	−0.04 (−0.10 to −0.06)	0.10
NTX (nM BCE/L)
Exercise	18.6 (3.1)	17.7 (2.8)	0.10	17.8 (2.7)	0.11	−0.90 (−1.1 to − 0.6)	0.12
Usual care	18.4 (2.7)	18.3 (2.5)	0.67	–	–	−0.90 (−1.1 to − 0.6)	0.12
RANK (pg/mL)
Exercise	27.4 (6.8)	26.7 (6.4)	0.14	26.6 (6.1)	0.14	−0.70 (−0.9 to − 0.4)	0.20
Usual care	26.9 (6.6)	26.4 (6.5)	0.34	–	–	−0.70 (−0.9 to − 0.4)	0.20
RANKL (pmol/L)
Exercise	142.5 (18.9)	146.1 (16.1)	0.09	145.7 (16.2)	0.09	3.6 (5.1 to 1.2)	0.14
Usual care	139.8 (18.1)	148.8 (18.9)	0.47	–	–	3.6 (5.1 to 1.2)	0.14
Whole body BMD (g/cm²)
Exercise	1.22 (0.1)	1.27 (0.1)	0.15	1.26 (0.1)	0.16	0.05 (0.04 to 0.02)	0.15
Usual care	1.20 (0.1)	1.19 (0.1)	0.29	–	–	0.05 (0.04 to 0.02)	0.15
Lumbar spine BMD (g/cm²)
Exercise	1.16 (0.09)	1.20 (0.09)	0.09	1.20 (0.1)	0.09	0.04 (0.03 to 0.01)	0.10
Usual care	1.15 (0.09)	1.14 (0.09)	0.57	–	–	0.04 (0.03 to 0.01)	0.10
Total hip BMD (g/cm²)
Exercise	0.91 (0.09)	0.94 (0.09)	0.17	0.94 (0.09)	0.17	0.03 (0.03 to 0.00)	0.18
Usual care	0.90 (0.09)	0.89 (0.08)	0.23	–	–	0.03 (0.03 to 0.00)	0.18
Trochanter BMD (g/cm²)
Exercise	0.72 (0.07)	0.74 (0.07)	0.18	0.74 (0.07)	0.20	0.02 (0.03 to 0.00)	0.22
Usual care	0.71 (0.06)	0.70 (0.06)	0.43	–	–	0.02 (0.03 to 0.00)	0.22
Femoral neck BMD (g/cm²)
Exercise	0.88 (0.1)	0.90 (0.1)	0.21	0.88 (0.7)	0.24	0.02 (0.03 to 0.00)	0.21
Usual care	0.87 (0.1)	0.86 (0.1)	0.23	–	–	0.02 (0.03 to 0.00)	0.21

Abbreviations: SD standard deviation, CI confidence interval, BMD bone mineral density, RANK receptor activator factor-kappa B, RANKL receptor activator factor-kappa B ligand
^aP value for repeated measures ANOVA comparing changes in the exercise group from baseline to post-intervention, and in the usual care group from baseline to post-intervention
^bP value for repeated measures ANOVA comparing changes in the exercise group from baseline to 3-month follow-up
^cP value for mixed model analysis comparing changes between the exercise and usual care group from baseline to post-intervention

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