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Further, testosterone castration via ADT has also been shown to remain at suppressed levels following resistance training indicating that this exercise mode is unlikely to alter the therapy purpose of reduced androgen levels.13, 14 Additionally, we have also observed (data not shown) that testosterone remains suppressed even immediately following an acute bout of high intensity resistance exercise. This is important given that several studies have demonstrated considerable elevation of testosterone in older men as a result of an acute bout of resistance training.38, 39 These findings collectively suggest that non androgen mediated mechanisms, such as neurological adaptations to training, and possible acute exercise induced elevations in other muscle growth mediators, such as hGH and IGF 1, are likely responsible for the observed changes in muscle function and hence physical performance following resistance training.Possible role of exercise during on and off treatment phasesThe biological rationale that prolonged ADT may facilitate progression from androgen dependence to androgen independence has lead to the adoption of intermittent regimens of ADT to reduce this risk and also diminish ADT related side effects.40 To date, only small non randomized trials on intermittent therapy have been reported, while two large clinical trials are currently in progress.40 Importantly, improvements in quality of life during off treatment phases have been observed,31, 41 while the effects of intermittent regimens of therapy on Androgen Deprivation and Sarcopenia Related Disorders remains to be determined. Nevertheless, the possible role of introducing a program of resistance exercise during on and off ADT therapy to improve and maintain physical function, particular during off ADT phases to enhance physical reserve capacity when undergoing periods of testosterone suppression is a potentially important strategy that should be considered in future clinical trials.Top of pageGuidelines for resistance exercise prescriptionDesigning a resistance training regimen involves the manipulation of a range of variables, such as the number of sets and repetitions, intensity of training (load lifted), duration of rest between sets and exercises, frequency of training and repetition velocity.

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