Evidence map›Paper›PMID 40764418›Full record

SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025

Effect of exercise on bone-related outcomes in patients with cancer affected by bone metastases or bone loss: a systematic review and meta-analysis.

Anita Borsati, Gloria Adamoli, Diana Giannarelli, Lorenzo Belluomini, Andrea Trevisan, Piero Schenal, Francesco Bettariga, Anna M Markarian, Federico Schena, Michele Milella and 3 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Anita BorsatiBiomedical, Clinical and Experimental Sciences, Department of Medicine, University of Verona, Verona, Italy.
Gloria AdamoliDepartment of Neurosciences, Biomedicine and Movement, University of Verona, Verona, Italy.
Diana GiannarelliFondazione Policlinico Universitario A. Gemelli, IRCCS-Epidemiology & Biostatistic, Rome, Italy.
Lorenzo BelluominiSection of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, P. Le L.A. Scuro 10, 37134, Verona, Italy.
Andrea TrevisanDepartment of Neurosciences, Biomedicine and Movement, University of Verona, Verona, Italy.
Piero SchenalDepartment of Neurosciences, Biomedicine and Movement, University of Verona, Verona, Italy.
Francesco BettarigaExercise Medicine Research Institute, Edith Cowan University, Perth, Australia.
Anna M MarkarianExercise Medicine Research Institute, Edith Cowan University, Perth, Australia.
Federico SchenaDepartment of Neurosciences, Biomedicine and Movement, University of Verona, Verona, Italy.
Michele MilellaSection of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, P. Le L.A. Scuro 10, 37134, Verona, Italy.
Robert U NewtonExercise Medicine Research Institute, Edith Cowan University, Perth, Australia.
Sara PilottoSection of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, P. Le L.A. Scuro 10, 37134, Verona, Italy.
Alice AvanciniDepartment of Neurosciences, Biomedicine and Movement, University of Verona, Verona, Italy. alice.avancini@univr.it.ORCID http://orcid.org/0000-0003-2439-4799

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis 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

methodsA 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).

resultsEighteen 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.

conclusionsOur 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.

Indexed as

Bone NeoplasmsExerciseExercise TherapyOsteoporosisBone DensityBone RemodelingBreast NeoplasmsHumansProstatic NeoplasmsRandomized Controlled Trials as TopicBone healthBone metastasesCancerOsteoporosisPhysical exercise

Identifiers

PMID40764418
PMCPMC12672621

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.