Associations Among Physical Activity, Skeletal Related Events, and Patient Reported Outcomes in Patients with Bone Metastases

Semin Oncol Nurs. 2022 Apr;38(2):151274. doi: 10.1016/j.soncn.2022.151274. Epub 2022 Apr 15.


Objectives: Emerging evidence supports exercise as a therapeutic intervention for patients with bone metastases. However, exercise prescription in practice is limited by concerns regarding skeletal-related events (SREs). This study examined associations among habitual physical activity levels, history of SREs, and patient reported outcomes in patients with bone metastases.

Data sources: A total of 58 patients with bone metastases (n = 45 breast cancer; n = 13 prostate cancer; mean time since cancer diagnosis 5.8 [4.7] years) were assessed. Habitual physical activity levels were collected by accelerometry. Standardized subjective assessment collected history of SREs, quality of life (EORTC-QLQ-C30 and EORTC-BM22), pain (Brief Pain Inventory), sleep quality (Pittsburgh Sleep Quality Questionnaire), and perceptions about exercise (Exercise Benefits/Barriers Scale). Participants spent a mean of 77.37% (standard deviation 14.3)% of waking hours sedentary and a mean of 20.14% (standard deviation 13.4)% of waking hours in light intensity activity. Almost half (n = 28) completed ≥150 min/wk moderate-to-vigorous intensity activity. Higher levels of moderate-to-vigorous intensity activity were associated with lower pain scores, better perceived physical function, lower functional interference scores, and better quality of life. Patients with a history of fracture since diagnosis spent more time sedentary and in light intensity activity in comparison to those with no fracture history (P < .05).

Conclusion: Moderate-to-vigorous intensity physical activity may have multiple benefits for patients with bone metastases. Reducing sedentary behavior may be a key target for patients with a history of fracture.

Implications for nursing practice: Oncology nurses play a key role in providing education on the benefits of exercise, overcoming barriers to physical activity and timely referrals.

Keywords: Bone metastases; Patient reported outcomes; Physical activity; Skeletal-related events.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bone Neoplasms* / secondary
  • Exercise
  • Humans
  • Male
  • Pain / etiology
  • Patient Reported Outcome Measures
  • Quality of Life*