Effect of exercise on bone-related outcomes in patients with cancer affected by bone metastases or bone loss: a systematic review and meta-analysis
Authors' conclusion
Our results suggest that, while exercise does not significantly increase BMD in patients with cancer and bone impairments when added to standard therapies, there are important variations across studies. High-intensity resistance and impact-loading training may be beneficial for specific bone sites and patient subgroups. Further research is warranted to identify optimal exercise modalities tailored to cancer type, treatment stage, and bone health status, including feasibility for patients with bone metastases.
Study context
- Population
- Patients with cancer (mainly breast and prostate) with compromised bone health (bone metastases or bone loss)
- Participants
- 1,478 patients18 studies
- Comparison
- Exercise vs supplementation or bone-targeted agents only
- Outcome
- BMD, bone mineral content and bone turnover markers
Methodological detailsrandom-effects models
- Random-effects models
Pooled result
As reported in the abstract
BMD (meta-analyses of 11 trials)
- Exercise
- Effect sizes (ES), whole-body bone mineral density (BMD) 0.16 (95% CI −0.10 to 0.41); P = 0.23
- Exercise
- ES, lumbar spine BMD 0.10 (95% CI −0.03 to 0.24); P = 0.14
- Exercise
- ES, hip BMD −0.06 (95% CI −0.77 to 0.64); P = 0.86
- Exercise
- ES, femoral neck BMD 0.07 (95% CI −0.08 to 0.21); P = 0.37
Further pooled results
Site-specific BMD in individual studies
- 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
- Mixed trends; some studies reported increased bone formation and reduced resorption, especially after 3 months of intervention
Original publication
Effect of exercise on bone-related outcomes in patients with cancer affected by bone metastases or bone loss: a systematic review and meta-analysis. Osteoporos Int. Published 6 August 2025. doi:10.
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