Exercise Preferences, Barriers, Motivators, Facilitators, and Perceived Benefits in Adults With Brain Tumours—A Systematic Review

INTRODUCTION: Adults with brain tumours face a poor prognosis, and physical and mental impairments reduce quality of life. Exercise can improve outcomes for this population; however, uptake and adherence remain low. Understanding exercise preferences, barriers, motivators, facilitators, and perceived benefits is crucial to optimising engagement. METHODS: A systematic search of Embase, MEDLINE, Scopus, CINAHL Complete, and the Nursing and Allied Health Database (2015-2025) was conducted. Studies were eligible if they included adults (≥ 18 years) with brain tumours and reported original qualitative or quantitative data. Screening, data extraction, and quality appraisal (Mixed Methods Appraisal Tool, 2018 version) were performed by two authors, with discrepancies resolved by a third. Data were synthesised narratively due to heterogeneity. RESULTS: Seven studies involving 163 participants were included, with mean ages of 48-63.5 years and 44.8% males. Most studies included individuals diagnosed with glioblastoma, glioma, or oligodendroglioma. Exercise preferences were reported in 5/7 studies. Participants preferred flexible, individualised exercise programs with varied delivery modes and session durations. Walking was the most commonly preferred activity in 2/7 studies (48%-56% of participants); 1/7 study reported 65% chose multiple activities, including cycling, swimming, and running. Barriers were identified in 5/7 studies, including symptom burden, cognitive impairment, treatment-related side effects, and psychological and external factors. Facilitators and motivators were reported in 3/7 studies and included support from carers and healthcare providers, structural enablers, and intrinsic motivations. Perceived benefits were identified in 5/7 studies, including improved physical function, energy, quality of life, well-being, self-efficacy, and social engagement. CONCLUSIONS: Exercise interventions for adults with brain tumours should be flexible, individualised, and supported by carers and healthcare providers. Moderate aerobic training is preferred, while resistance training remains underexplored. Addressing barriers and providing structured support may enhance uptake and adherence. Further research is needed to establish optimal program characteristics across disease stages.