Author(s): PÓVOAS, S.1,2,6, MARTINS, R.1, PEREIRA, R.1,3, MESQUITA, S.4, CARNEIRO, D.4, SILVA-RAMOS, M.4,5, KRUSTRUP, P.6, Institution: UNIVERSITY OF MAIA, Country: PORTUGAL, Abstract-ID: 2117

INTRODUCTION:
Recreational football (RF) has demonstrated potential in improving health outcomes and attenuating treatment-related adverse effects among prostate cancer (PCa) patients. However, the physiological demands of RF can exceed the functional capacity or exercise tolerance of inactive PCa survivors. Therefore, walking football (WF) may serve as a lower-intensity precursor within an RF-based rehabilitation framework, by facilitating a safer transition to RF.
METHODS:
Twelve inactive male PCa patients (age=73±3 years; stature=165±6 cm; body mass=73.2±10.0 kg; fat mass=27.8±4.5%; SBP=137±18 mmHg, DBP=79±11 mmHg) participated in this intervention study consisting of a 3-month WF phase followed by a 4-month RF phase. Each phase consisted of three weekly 60-minute training sessions comprising a warm-up, strength and balance exercises, followed by small-sided games of either WF or RF. Heart rate (HR) was continuously monitored to determine mean and peak values, as well as time spent across six HR zones (<50%, 61-70%, 71-80%, >80%, 81-90%, and 91-100% HRmax). Training sessions’ rating of perceived exertion (RPE) was assessed for respiratory, muscular, and global domains, along with fun levels. Falls and injuries were recorded during all training sessions and expressed as number per 1000 training hours.
RESULTS:
RF elicited significantly higher mean HR (73±10%HRmax) and peak HR (82±10%HRmax) compared to WF (mean: 71±12%HRmax, p=0.024, d=0.98, 95%CI: 0.27-1.65; peak: 78±12% HRmax, p=0.006, d=0.75, 95%CI: 0.10-1.40). Time spent across all HR zones showed no significant differences (p>0.05). Global RPE was significantly higher during RF (5.0±1.7 AU) vs. WF (4.2±2.1 AU, p=0.046, d=0.65, 95%CI: 0.01-1.27), as well as muscular RPE (RF: 5.0±2.1 AU vs. WF: 4.0±1.9 AU, p=0.027, d=0.73, 95%CI: 0.08-1.36), whereas respiratory RPE was similar (p>0.05). Fun levels were consistently high and not significantly different between WF and RF (WF: 7.7±1.6 AU; RF: 8.1±1.3 AU, p=0.056, d=0.62, 95%CI: 0.02-1.23). However, RF showed a significantly higher fall incidence compared to WF (RF: 114±83 vs. WF: 62±58 falls/1000h; p=0.03, d=0.76, 95%CI: 0.09-1.40), although injury rates due to falls did not differ significantly (RF: 1.5±5.1 vs. WF: 0.0±0.0 injuries/1000h; p>0.05).
CONCLUSION:
RF showed higher cardiovascular stimulus than WF, although both elicited sufficient time in target HR zones to provide marked health benefits for the PCa patients. Both modalities showed high fun levels, supporting long-term adherence. The fall incidence was 2-fold higher in RF compared to WF, albeit this did not result in major injuries. These findings support WF as a suitable precursor for inactive PCa patients within a RF framework, facilitating a safe progression to RF while preserving cardiovascular load.
This work was supported by National Funds by FCT - Foundation for Science and Technology, under the project UID/04045/2025 (https://doi.org/10.54499/UID/04045/2025).