Benefits of a 12 weeks-individually tailored physical activity program in patients with Cushing’s disease in remission and controlled acromegaly

Background: Patients with controlled Cushing’s disease (CD) and acromegaly (ACRO) often experience persistent musculoskeletal dysfunction and impaired quality of life (QoL) despite biochemical normalization. Although undergoing supervised physical activity is a clear unmet need of pituitary patients, evidence on the effectiveness of individually tailored exercise programs in these populations is scanty . Objective: The aim of this pilot study was to evaluate the effectiveness of a 12-week individually tailored and supervised exercise program on muscle function, bone health, and patient-reported outcomes (PROMs) in patients with biochemically controlled CD and ACRO. Methods: Twenty patients (10 women with CD in remission, 10 men with controlled ACRO) participated in a structured program combining aerobic and resistance exercises, supervised by professional trainers, three times a week over 12 weeks. Outcomes assessed at baseline and post-intervention included, grip strength and physical performance on gait speed, timed up-and-go, chair stand test, muscle structure and quality on ultrasound examination, body composition and bone mineral density (BMD), as measured using dual-x-absorptiometry (DXA), and QoL, as evaluated using disease-specific (CushingQoL, AcroQoL) and generic (SF-12, PANAS, PHQ-9, and GAD-7) questionnaires. Results: After the 12-week intervention, significant improvements were observed in physical performance tests (p<0.05 for all parameters vs. baseline) in both CD and ACRO patients. Ultrasound-measured muscle thickness increased CD patients after completion of the program (p<0.05), while a decreased echogenicity was found in ACRO patients (p<0.05) CD patients demonstrated significant improvements in waist circumference, diastolic blood pressure, lean mass fraction, trunk fat fraction, and femoral BMD (p<0.05). Conclusion: An individually tailored, supervised 12-week exercise intervention significantly enhanced muscle structure and physical performance in patients with controlled CD and ACRO. Physical activity trainers should be included in the multidisciplinary team dedicated to the management of pituitary diseases