Effect of exercise on bone-related outcomes in patients with cancer affected by bone metastases or bone loss: a systematic review and meta-analysis
Abstract
Introduction: This systematic review and meta-analysis aimed to evaluate the effects of exercise interventions on bone mineral density (BMD), bone mineral content (BMC), and bone turnover markers in patients with cancer and compromised bone health.
Materials and methods: A comprehensive search of four electronic databases was conducted to identify randomized controlled trials evaluating the effect of exercise intervention compared to supplementation or bone-targeted agents only on BMD, BMC and bone turnover markers. Meta-analyses were performed using random-effects models to calculate effect sizes (ES) with 95% confidence intervals (CI).
Results: Eighteen studies were included, involving 1,478 patients with mainly breast and prostate cancer. Meta-analyses of 11 trials showed no significant effect of exercise on whole-body (ES: 0.16, 95% CI: -0.10 to 0.41; p = 0.23), lumbar spine (ES: 0.10, 95% CI: -0.03 to 0.24; p = 0.14), hip (ES: -0.06, 95% CI: -0.77 to 0.64; p = 0.86), or femoral neck (ES: 0.07, 95% CI: -0.08 to 0.21; p = 0.37) BMD. However, individual studies reported improvements in lumbar spine and hip BMD following resistance or high-impact training. In patients with bone metastases, resistance training increased BMD at metastatic vertebrae. Bone turnover markers showed mixed trends, with some studies reporting increased bone formation and reduced resorption, especially after 3 months of intervention.
Conclusions: Our results suggest that, while exercise does not…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,478 participants or records.
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