# Movement-Based Interventions in Patients Affected by Bone Metastases: Impact on Physical Function and Functional Autonomy—A Systematic Review

## TL;DR

This paper reviews evidence showing that exercise is safe and can improve physical function and independence in cancer patients with bone metastases.

## Contribution

It provides a systematic review of movement-based interventions specifically for patients with bone metastases, highlighting their safety and benefits.

## Key findings

- Structured physical activity improves mobility, muscle strength, and endurance in patients with bone metastases.
- Exercise interventions enhance performance in daily activities and reduce fatigue without serious adverse events.
- Personalized exercise should be integrated into supportive care for these patients.

## Abstract

Patients with advanced cancer often develop bone metastases, which can cause pain, weakness, and loss of independence in daily life. These changes not only reduce physical function but also have a strong impact on quality of life. Staying active and exercising may help to preserve mobility, strength, and independence, but many patients and health professionals are unsure whether physical activity is safe in this context. This study brings together and summarizes the available evidence on exercise programs for people with bone metastases. The results show that structured physical activity is safe and can improve walking ability, muscle strength, energy levels, and performance in everyday tasks. These findings highlight the importance of including personalized exercise as part of supportive care, with the potential to enhance both clinical practice and future research in cancer care.

Background: Bone metastases are a common complication in patients with advanced cancer. These patients often experience a decline in physical function and autonomy, particularly in the ability to perform Activities of Daily Living, and structured movement-based interventions may represent an important supportive strategy. The aim of this study is to describe the available evidence regarding the impact of physical activity and exercise interventions on functional status and ADL performance in patients with bone metastases. Methods: A systematic literature review was conducted in PubMed, Scopus, Embase, Web of Science, and CINAHL database up to March 2025 and reported according to PRISMA guidelines. Eligible studies included adults (≥18 years) with confirmed bone metastases who underwent physical activity interventions designed to enhance functional status and ADLs. Studies’ methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools, selected according to study design. Results: Eleven studies were included: four randomized controlled trials, four quasi-experimental studies, one randomized feasibility trial, one cross-sectional observational study, and one case report. Despite heterogeneity in intervention type, duration, and outcome measures, most studies reported improvements in physical function, including mobility, muscle strength, walking capacity, and endurance, as well as enhanced performance in ADLs and reductions in fatigue. No serious adverse events were reported. Conclusions: Structured physical activity appears safe and may improve function and independence in patients with bone metastases. These findings support the integration of individualized exercise programs into multidisciplinary supportive care.