Social distancing, or the utmost limitation of physical interpersonal contact still remains the foremost preventive measure in order to limit further spread of COVID-19. As limiting the risk of transmission is of particular significance in the elderly and in cancer patients, as this population is being reported to harbor increased risk of serious complications due to COVID-19, many patients are choosing home-isolation as the preferred method to prevent transmission of the disease. Unfortunately, this pandemic-related reluctance of leaving home may be associated with decreased levels of physical activity, which may negatively impact the cardiovascular, musculoskeletal and general health. This is of special importance in the population of prostate cancer patients, as many of them are undergoing androgen deprivation therapy, which is a known factor to increase the risk of cardiovascular events and osteoporotic fractures, and physical activity is a recommended measure to counteract those complications. It has been shown in the literature that chair-based exercise programs may improve mobility and function, cardiorespiratory fitness, as well as mental health, which makes them a good alternative if no other form of physical activity is available to the patient. Thus the role of urologist is to encourage the patient and provide them with instructions on how to maintain physical activity while staying at home.
In the video we present a chair-based exercise program we have developed for elderly home-isolated cancer patients, with frail men undergoing androgen deprivation therapy for metastatic prostate cancer being our intended target-group. The exercises we present can be easily performed in the domestic environment and require either no training equipment, or a simple resistance band or a rubber ball. The program consists of sixteen exercises intended to strengthen various groups of muscles. Depending on the agility of the patient, the program can be easily completed within fifteen minutes of exercise. In order to adhere to the World Health Organization guideline in regards to the recommended daily physical activity time, we suggest that patients engage in this muscle strengthening training program at least on two days a week and, if feasible, the program is accompanied by at least 20 minutes of daily aerobic exercising, in bouts of at least 10 minutes duration. This aerobic activity within domestic environment may include activities like vigorous walking around the house or stair climbing.
Given the potential beneficial effect of chair-based physical activity in home-isolated elderly patients, especially in prostate cancer patients undergoing androgen deprivation therapy, to provide the patient with an exercise program should be a routine part of every follow-up visit and we hope that this video will be able to serve as a helpful tool in daily outpatient practice.