Physical activity and exercise in cancer patients with bone metastases
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memo https://doi.org/10.1007/s12254-020-00664-3
Physical activity and exercise in cancer patients with bone metastases Winfried Habelsberger
Received: 18 September 2020 / Accepted: 26 October 2020 © Springer-Verlag GmbH Austria, part of Springer Nature 2020
Summary Physical activity and exercise can have numerous positive effects on various disease- and therapy-related symptoms across the continuum of cancer disease. These include an improvement in quality of life, physical function, aerobic fitness, muscle strength and muscle mass, bone density and a reduction of insomnia, psychological distress, pain and fatigue. Although no higher fracture incidence could be found in several studies, exercise is still often considered contraindicated in patients with bone metastases due to concerns about skeletal-related events such as pathologic fractures, spinal cord compression, aggravating pain, increased mortality and higher health care costs. This short, narrative review reports general considerations about physical activity in patients with cancer. In particular, it focuses on principles, precautions and contraindications regarding exercise recommendations for patients with metastatic bone disease in order to implement safe and efficient exercise interventions. Keywords Cancer · Mirels scoring system · Fracture risk assessment · Spinal instability neoplastic score · Exercise intervention
Physical activity and exercise in cancer Surviving cancer usually means enduring significant and prolonged medical treatments. Especially the long-term systemic treatment of patients with cancer and bone metastases has a significant impact on aer-
Dr. W. Habelsberger, MSc () Department of Physical Medicine and Rehabilitation, Ordensklinikum Linz Elisabethinen, Fadingerstraße 1, 4020 Linz, Austria [email protected]
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obic endurance, muscle strength, fatigue and physical functioning [1]. During cancer treatment, the purpose of exercise interventions is to maintain physical fitness and to prevent muscle loss, fat gain, fatigue, and deterioration in quality of life (QoL). Posttreatment interventions are typically aimed at accelerating recovery, improving physical fitness and QoL, reducing fatigue, psychic distress and the risk of developing new cancer and comorbid conditions such as cardiovascular disease, diabetes and osteoporosis [2]. Patients who stay active may benefit at all stages of the cancer care pathway as is indicated by higher survival rates [3, 4], maintenance of QoL, better sleep [5] and reduced fatigue [6] and risk of falls [7]. Comparably significant positive effects of exercise on QoL and physical function across patients with different demographic and clinical characteristics were found in a meta-analysis [8]. The effects did not differ significantly across subgroups of age, gender, education level, marital status, body mass index (BMI), cancer type, metastatic stage or treatment. Moreover, exercise was found to be equally effective during and after cancer treatment. Supervised exercises were tw
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