TY - JOUR
T1 - Exercise Recommendation for People With Bone Metastases
T2 - Expert Consensus for Health Care Providers and Exercise Professionals
AU - Campbell, Kristin L.
AU - Cormie, Prue
AU - Weller, Sarah
AU - Alibhai, Shabbir M.H.
AU - Bolam, Kate A.
AU - Campbell, Anna
AU - Cheville, Andrea L.
AU - Dalzell, Mary Ann
AU - Hart, Nicolas H.
AU - Higano, Celestia S.
AU - Lane, Kirstin
AU - Mansfield, Sami
AU - McNeely, Margaret L.
AU - Newton, Robert U.
AU - Quist, Morten
AU - Rauw, Jennifer
AU - Rosenberger, Friederike
AU - Santa Mina, Daniel
AU - Schmitz, Kathryn H.
AU - Winters-Stone, Kerri M.
AU - Wiskemann, Joachim
AU - Goulart, Jennifer
PY - 2022/5/1
Y1 - 2022/5/1
N2 - PURPOSE: Exercise has been underutilized in people with advanced or incurable cancer despite the potential to improve physical function and reduce psychosocial morbidity, especially for people with bone metastases because of concerns over skeletal complications. The International Bone Metastases Exercise Working Group (IBMEWG) was formed to develop best practice recommendations for exercise programming for people with bone metastases on the basis of published research, clinical experience, and expert opinion. METHODS: The IBMEWG undertook sequential steps to inform the recommendations: (1) modified Delphi survey, (2) systematic review, (3) cross-sectional survey to physicians and nurse practitioners, (4) in-person meeting of IBMEWG to review evidence from steps 1-3 to develop draft recommendations, and (5) stakeholder engagement. RESULTS: Recommendations emerged from the contributing evidence and IBMEWG discussion for pre-exercise screening, exercise testing, exercise prescription, and monitoring of exercise response. Identification of individuals who are potentially at higher risk of exercise-related skeletal complication is a complex interplay of these factors: (1) lesion-related, (2) cancer and cancer treatment-related, and (3) the person-related. Exercise assessment and prescription requires consideration of the location and presentation of bone lesion(s) and should be delivered by qualified exercise professionals with oncology education and exercise prescription experience. Emphasis on postural alignment, controlled movement, and proper technique is essential. CONCLUSION: Ultimately, the perceived risk of skeletal complications should be weighed against potential health benefits on the basis of consultation between the person, health care team, and exercise professionals. These recommendations provide an initial framework to improve the integration of exercise programming into clinical care for people with bone metastases.
AB - PURPOSE: Exercise has been underutilized in people with advanced or incurable cancer despite the potential to improve physical function and reduce psychosocial morbidity, especially for people with bone metastases because of concerns over skeletal complications. The International Bone Metastases Exercise Working Group (IBMEWG) was formed to develop best practice recommendations for exercise programming for people with bone metastases on the basis of published research, clinical experience, and expert opinion. METHODS: The IBMEWG undertook sequential steps to inform the recommendations: (1) modified Delphi survey, (2) systematic review, (3) cross-sectional survey to physicians and nurse practitioners, (4) in-person meeting of IBMEWG to review evidence from steps 1-3 to develop draft recommendations, and (5) stakeholder engagement. RESULTS: Recommendations emerged from the contributing evidence and IBMEWG discussion for pre-exercise screening, exercise testing, exercise prescription, and monitoring of exercise response. Identification of individuals who are potentially at higher risk of exercise-related skeletal complication is a complex interplay of these factors: (1) lesion-related, (2) cancer and cancer treatment-related, and (3) the person-related. Exercise assessment and prescription requires consideration of the location and presentation of bone lesion(s) and should be delivered by qualified exercise professionals with oncology education and exercise prescription experience. Emphasis on postural alignment, controlled movement, and proper technique is essential. CONCLUSION: Ultimately, the perceived risk of skeletal complications should be weighed against potential health benefits on the basis of consultation between the person, health care team, and exercise professionals. These recommendations provide an initial framework to improve the integration of exercise programming into clinical care for people with bone metastases.
KW - Cancer care
KW - International Bone Metastases Exercise Working Group (IBMEWG)
KW - Bone metastases
KW - Exercise
UR - http://www.scopus.com/inward/record.url?scp=85129081019&partnerID=8YFLogxK
U2 - 10.1200/OP.21.00454
DO - 10.1200/OP.21.00454
M3 - Article
C2 - 34990293
AN - SCOPUS:85129081019
SN - 2688-1527
VL - 18
SP - e697-e709
JO - JCO Oncology Practice
JF - JCO Oncology Practice
IS - 5
ER -
