Kristin L Campbell1, Prue Cormie2,3, Sarah Weller1,4, Shabbir M H Alibhai5, Kate A Bolam6, Anna Campbell7, Andrea L Cheville8, Mary-Ann Dalzell9, Nicolas H Hart10,11, Celestia S Higano12, Kirstin Lane13, Sami Mansfield14, Margaret L McNeely15, Robert U Newton10, Morten Quist16, Jennifer Rauw4, Friederike Rosenberger17, Daniel Santa Mina18, Kathryn H Schmitz19, Kerri M Winters-Stone20, Joachim Wiskemann17, Jennifer Goulart21. 1. Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada. 2. Australian Catholic University, Melbourne, Australia. 3. Peter MacCallum Cancer Centre, East Melbourne, Australia. 4. BC Cancer, Vancouver, British Columbia, Canada. 5. Toronto General Hospital and University of Toronto, Toronto, Ontario, Canada. 6. Karolinska Institute, Stockholm, Sweden. 7. Edinburgh Napier University, Edinburgh, Scotland. 8. Mayo Clinic, Rochester, NY. 9. Oncology Division of the Canadian Physiotherapy Association, Montreal, Quebec, Canada. 10. Edith Cowan University, Joondalup, Australia. 11. Queensland University of Technology, Brisbane, Australia. 12. Vancouver Prostate Centre, Vancouver, British Columbia, Canada. 13. University of Victoria, Victoria, British Columbia, Canada. 14. University of Kansas Cancer Center, Kansas City, MO. 15. University of Alberta, Edmonton, Alberta, Canada. 16. University of Copenhagen, Copenhagen, Denmark. 17. National Center for Tumor Diseases, Heidelberg, Germany. 18. University of Toronto, Toronto, Ontario, Canada. 19. Penn State University, Hershey, PA. 20. Oregon Health and Sciences University, Portland, OR. 21. BC Cancer, Victoria, British Columbia, Canada.
Abstract
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.
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.
Authors: Corinna Meyer-Schwickerath; Maximilian Köppel; Rea Kühl; Janina Bujan Rivera; Angeliki Tsiouris; Gerhard Huber; Joachim Wiskemann Journal: Support Care Cancer Date: 2022-08-29 Impact factor: 3.359
Authors: Ria Joseph; Nicolas H Hart; Natalie Bradford; Oluwaseyifunmi Andi Agbejule; Bogda Koczwara; Alexandre Chan; Matthew P Wallen; Raymond J Chan Journal: Support Care Cancer Date: 2022-05-26 Impact factor: 3.359
Authors: Margaret I Fitch; Raymond J Chan; Imogen Ramsey; Alexandre Chan; Andreas Charalambous; Yin Ting Cheung; H S Darling; Lawson Eng; Lisa Grech; Nicolas H Hart; Deborah Kirk; Sandra A Mitchell; Dagmara Poprawski; Elke Rammant Journal: Support Care Cancer Date: 2022-09-29 Impact factor: 3.359