Article

Metastatic disease is a frequent complication of advanced cancer, with bone
representing one of the most common sites of metastatic occurrence. Patients with
bone metastases receive long-term systemic treatments that have a significant
attritional impact on muscle strength, fatigue, and physical functioning.
Physical rehabilitation involving exercise and physical activity prescription has
a considerable role in counteracting these changes; however, exercise is often
perceived as a contraindication in the presence of bone metastases due to
concerns about aggravating skeletal related events. This article examines the
physical sequelae of bone metastases and outlines the factors for consideration
with exercise prescription in metastatic bone disease, including bone health,
pain levels, and oncologic treatment. This article includes a comprehensive
review of the evidence from trials of exercise prescription in this population,
including the efficacy and safety outcomes of exercise interventions. Exercise
interventions for patients with bone metastases are associated with positive
physical and self-reported outcomes. Studies reviewed reporting adverse events
did not find a high fracture incidence with exercise in comparison with control
participants, or an association between exercise and fracture risk. The need to
individualize exercise prescription and adapt exercises to patient ability were
reinforced in all papers reviewed. Exercise prescription to patients with bone
metastases does involve complex decision making; however, a number of tools are
available that may inform both the assessment of patients and the prescription of
exercise.
LEVEL OF EVIDENCE: NA.
CI - Copyright (c) 2018 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS