OBJECTIVE: To investigate whether functionally-based resistance exercise could improve strength, physical function and disability among prostate cancer survivors (PCS) on androgen deprivation therapy (ADT). We also explored potential mediators of changes in outcomes from exercise. DESIGN: Randomized controlled trial. SETTING: Academic medical center. PARTICIPANTS: 51 PCS (mean age 70.2 years) on ADT. INTERVENTIONS: PCS were randomized to moderate-vigorous intensity resistance training or stretching (placebo control) for one year. MAIN OUTCOME MEASURES: Maximal leg press and bench press strength, objective and self-report physical function and self-report disability. Hierarchical linear modeling was used to test for significant group x time differences adjusting for covariates. RESULTS: Retention in the study was 84%, median attendance to supervised classes was 84% in the resistance group, and no study-related injuries occurred. Maximal leg (p = 0.032) and bench press (p = 0.027) strength improved from one year of resistance training compared to little change from stretching. Self-report physical function improved with resistance training compared to decreases from stretching (p = 0.016), while disability lessened more with resistance training than stretching (p = 0.018). One-year change in leg press strength mediated the relationship between group (resistance or stretching) and one-year change in self-report disability (p < 0.05). CONCLUSIONS: One year of resistance training improved muscle strength in androgen-deprived PCS. Strengthening muscles using functional movement patterns may be an important feature of exercise programs designed to improve perceptions of physical function and disability. Findings from this study contribute to the mounting evidence that exercise become a routine part of clinical care in older men with advanced prostate cancer.

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