Exercise Interventions in Children, Adolescents and Young Adults With Paediatric Bone Tumours-A Systematic Review

Bone tumours present significant challenges for affected patients, as multimodal therapy often leads to prolonged physical limitations. This is particularly critical during childhood and adolescence, as it can negatively impact physiological development and psychosocial resilience. Exercise programmes have demonstrated beneficial effects regarding these aspects in both paediatric oncology and orthopaedic rehabilitation. However, evidence on patients with paediatric bone tumours remains scattered. This review summarises the existing literature on exercise interventions for children, adolescents and young adults with bone tumours. A systematic literature search was conducted across four databases until March 2025. References of retrieved articles were screened for additional relevant studies. Methodological quality was assessed through critical appraisals. Seven studies, including 169 patients and survivors aged 4-41 years, met the inclusion criteria; however, the methodological quality was limited. Interventions were conducted at various treatment phases, including prehabilitation, early and late rehabilitation. Exercise modalities varied and were frequently combined, with strength and functional training being the most common. Outcome measures differed, assessing parameters such as physical function and patient-reported outcomes. Individualised, multimodal exercise programmes should be implemented early. They are safe, feasible and can improve physical function and quality of life. High-quality research is needed for more substantial evidence.