Physical activity recommendations for cancer survivors living with bony metastases: views of oncologic healthcare providers

Exercise Recommendation for People With Bone Metastases: Expert Consensus for Health Care Providers and Exercise Professionals

“…However, less than half of the physicians and nurse practitioners (43%) felt confident to recommend exercise to people with bone metastases. 21 The IBMEWG agreed that the term medical consultation versus clearance was the most appropriate term for communication between the exercise professional and health care provider. The goal of such medical consultation is to establish two-way communication to assess the cost to benefit-risk of an exercise prescription, as it can be difficult for health care providers to feel that they have enough understanding of exercise to provide medical clearance and for exercise professionals to obtain or interpret all the desired clinical information to assess risk, especially without access to the medical chart (Appendix Table A1, online only).…”

“…To facilitate respondents providing an exercise recommendation to individuals, the most frequently cited resource identified was a set of clinical guidelines for exercise in this population (25%), an easy-to-use screening scale (20%), and a consult with a qualified exercise professional (13%). 21 The IBMEWG acknowledged that in the absence of literature, all people with bone metastases can be at risk of an exercise-related skeletal complication, but this should not preclude prescribing exercise. 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) person-related (Table 2).…”

Exercise counselling and referral in cancer care: an international scoping survey of health care practitioners’ knowledge, practices, barriers, and facilitators

“…Identified barriers to HCPs implementing exercise guidelines include perceiving some cancer survivors as unsuitable relative to current guidelines, safety concerns, limited time, perceived scope of practice, insufficient knowledge, unwillingness of cancer survivors to adopt recommendations, and anticipated failure in altering individuals’ behaviour [ 26 , 27 , 30 – 34 ]. Studies have reported that the greatest barrier to oncology HCPs discussing exercise with cancer survivors was limited knowledge about the existence and implementation of clinical exercise guidelines, despite appreciating the benefits of exercise [ 35 , 36 ]. Specifically, most were either not aware of exercise guidelines in cancer, or had poor knowledge on when, how, and which cancer survivors to refer to exercise programs or exercise specialists [ 32 ], highlighting a knowledge-to-action (KTA) gap.…”

Exercise for people with bone metastases: MASCC endorsed clinical recommendations developed by the International Bone Metastases Exercise Working Group

“…Following an in-person planning session at the American College of Sports Medicine (ACSM) annual meeting in 2018, the IBMEWG first explored the knowledge, beliefs, and attitudes of Canadian oncologic health care providers through a web-based survey [6,7], highlighting their agreement that physical activity is important and safe for people with bone metastases, while noting they required more information before being able to recommend physical activity to these people with advanced cancer. Second, the IBMEWG conducted a systematic review [8] to synthesise evidence of prescribed exercise for people with bone metastases, identifying 17 unique trials involving 645 people with sclerotic or osteolytic bone metastases; demonstrating various modes of aerobic, resistance, or sportbased exercise were safe and feasible, while concluding that future larger randomised controlled trials are needed to facilitate sufficient statistical power that will underpin intervention efficacy for this patient population.…”