Caroline Inga Shealy, Lauren C. Bates, Sasha Riley, Cameron Stopforth, Kaileigh Moertl, Kyle Edgar, Lee Stoner, FACSM, Erik D. Hanson, FACSM. University of North Carolina at Chapel Hill, Chapel Hill, NC, NC.

Introduction and Objective: Cardiorespiratory fitness (CRF) is associated with lower all-cause mortality and reduced chronic disease risk, which is important for Breast (BCa) and prostate (PCa) cancer survivors in the prevention of secondary disease and recurrence. Exercise increases CRF (measured via volume of oxygen (VO2) assessment); however, the extent to which home-based exercise improves CRF in BCa/PCa is unclear. The objective of this meta-analysis was to investigate the effects of home-based exercise on CRF in adult (>18 year) BCa/PCa survivors. Methods: Electronic databases were searched from inception to January 2021. Studies reporting pre-and post-intervention VO2 values were eligible for inclusion. Standardized mean differences (SMD) were calculated to account for differing assessment types. Effects estimates were pooled using a 3-level model with restricted maximum likelihood estimation. The alpha-level was set at 5% for the pooled estimate and 10% for effect moderators. SMD of <0.2, 0.2, 0.5, and 0.8 were defined as trivial, small, moderate, and large respectively. Results: Seven articles with 14 effects (n=312) met inclusion criteria. Overall, home-based exercise led to small improvements in CRF [SMD= -0.02 to 1.94; majority = positive/beneficial 93%]. The pooled effect revealed a small improvement in CRF (SMD= 0.45, 95% CI: -0.01 to 0.91, p=0.056). Both aerobic (SMD= 1.27, 95% CI: 0.51, 2.02, p= 0.001) and strength (SMD=0.89, 95% CI: 0.15, 1.64, p= 0.018) training resulted in large, significant (beneficial) increases in CRF whereas a small, non-significant increase was observed in combined (p= 0.286). Neither measurement type, cancer type, study duration, participant age or VO2 unit expression were significant effect moderators. Conclusions: Following home-based exercise training there was a small (SMD=0.45) improvement in CRF significant at the p= 0.056 level. Aerobic exercise training had the largest (SMD= 1.27) improvement in CRF followed by strength training (SMD= 0.89), and then combined (SMD= 0.28). Therefore, if the primary goal of the exercise training is to improve CRF, future studies should utilize aerobic exercise such as walking for BCa/PCa survivors at home.

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