Translating Exercise Recommendations For People With Bone Metastases: Moving Guidelines Into Professional Development Resources

INTRODUCTION: Recommendations from the International Bone Metastases Exercise Working Group, published in 2022, emphasize that regular exercise may benefit people with bone metastases. Despite this, adopting guidelines into clinical practice remains challenging. A leading barrier includes limited knowledge among exercise professionals on how to safely assess, prescribe and tailor exercise for this population. Recommendations endorse physical therapists and clinical exercise physiologists as the professionals responsible for prescribing exercise to this population, but limited education is available for these providers. Evidence-based professional development (PD) resources are necessary to fill this gap. PURPOSE: The purpose of this project was to assess the preferences and barriers of exercise professionals to accessing PD products related to bone metastases. METHODS: An electronic survey gathering demographic and professional caseload information was distributed to exercise professionals who may work with people with bone metastases, along with a questionnaire identifying preferences for PD materials and barriers to participation. Based on data collected, PD products were developed using the experience-based co-design process. RESULTS: A total of 183 international exercise professionals completed the survey, including a mix of physical therapists (n = 56), clinical exercise physiologists (n = 38), exercise specialists (n = 26), fitness instructors (n = 21) and kinesiologists (n = 7). Of those, 92% indicated working with people with bone metastases. Over 80% indicated that more PD resources were needed. Preferences for content included focusing on exercise safety, feasibility, and prescription considerations, and preferred format included online live webinars, and pre-recorded video, audio, or written materials. In-person courses were less desirable. Barriers to accessing PD included cost and travel. CONCLUSIONS: A lack of discipline-specific training for exercise professionals remains a significant barrier to implementing current exercise recommendations for individuals living with bone metastases. Exercise professionals reported preferences and barriers related to PD resources helped generate a framework for developing PD materials that will be launched in 2025.