Advancing exercise recommendations for people with bone metastases: a collaborative approach to knowledge mobilization using experience-based co-design
Related Experiment Video
Updated: Nov 6, 2026
Models of Bone Metastasis
Published on: September 4, 2012
Kelcey A Bland1,2, Sarah E Neil-Sztramko3,4, Michelle B Nadler5
1Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Background:
People with bone metastases have historically been advised to limit exercise due to concerns about skeletal complications. However, evidence-based recommendations from the International Bone Metastases Exercise Working Group (IBMEWG) highlight the important benefits of regular exercise. To support the adoption of the IBMEWG recommendations into clinical practice, we used an experience-based co-design (EBCD) approach to collaborate with key knowledge users in developing knowledge products and a dissemination plan.
Methods:
Three knowledge-user groups participated: 1) people with bone metastases or caregivers, 2) oncology healthcare providers (e.g., physicians, nurses, allied health), and community-based exercise professionals (e.g., physiotherapists, clinical exercise physiologists, kinesiologists). Through facilitated meetings, participants co-developed knowledge products and a dissemination strategy. External survey feedback from international participants was collected prior to knowledge product launch. Knowledge user satisfaction with the co-design process was assessed using the Public and Patient Engagement Evaluation Tool.
Results:
Twenty-nine knowledge users across Canada participated (n = 10 patients/caregivers, n = 9 healthcare providers, and n = 10 exercise professionals). Knowledge products prioritized for co-design were as follows: 1) a health information form; 2) a patient education handout; and 3) a patient education webinar. The Bone Metastases and Exercise Hub was created to share the knowledge products ( https://cancerexercise.med.ubc.ca/bmehub/ ). External feedback from international survey participants rated the design, format, and content of the patient handout and health information form favourably. All knowledge users who provided feedback on the co-design process were satisfied with their participation. The co-designed dissemination plan involves various communication channels and partnerships with Canadian and international organizations.
Conclusions:
Our co-designed knowledge products aim to support people with bone metastases to exercise safely and may improve healthcare providers' and exercise professionals' confidence in offering evidence-based guidance. Meaningful collaboration with knowledge users may enhance the relevance, utility, and acceptability of knowledge products compared with researcher-designed materials.
