Overcome the Fear of Exercise in Patients With Bone Metastases: A Qualitative Study on Patients' Perception

Purpose

This qualitative study aimed to explore the experiences of patients with cancer and bone metastases who participated in a personalized exercise program.

Methods

Individual interviews were conducted through purposeful sampling of patients who attended the 3-month supervised exercise program. Using a phenomenological approach, semi-structured questions were developed to investigate the benefits, risks, facilitators, and barriers related to exercise. Data were analyzed using inductive thematic analysis.

Results

Thirteen patients with mixed cancer types participated in the study. Patients recognized the physical and psychological benefits of exercise, such as improvements in physical fitness, bone health, reduction of symptoms, especially pain and fatigue, and increase in self-confidence. While they did not perceive any disadvantage from participating in the program, they acknowledged the risk of bone fractures or exacerbation of lesions if the intervention is not tailored and supervised. The program's structure, including the involvement of dedicated specialists, has been reported as a fundamental pillar. Among the modulators for participation and adherence, comorbidities associated with bone metastases, logistic barriers, and lack of social support may be obstacles. Conversely, recommendations from the oncologist, personal motivation, and peer support were found to be facilitators of practice.

Conclusions

Patients with bone metastases expressed a broad range of benefits from participation in a structured exercise program. Several modulators may affect uptake and adherence and thus should be considered when designing a dedicated program.