INTRODUCTION: The spine is the most common location of bone metastases affecting around 20% of adults with cancer. The purpose of this systematic review was to identify the effect of spinal exercises that have been utilized in adults with metastatic spine disease and to review the reported adverse events. METHODS: A systematic literature search was conducted using PubMed, CINAHL, Embase, and PEDro for randomized controlled trials published between January 2011 and June 2023. Extraction was performed by coauthor teams. Quality and bias were evaluated using Cochrane Risk of Bias 2.0 (RoB 2). RESULTS: A total of 212 records were assessed, 8 of which qualified for inclusion in this review. All were from the same 2 clinical trial protocols. The 8 studies included 116 adults with spine metastasis. The supervised exercise interventions, conducted by a physical therapist or exercise physiologist, included isometric spinal stabilization exercises supervised for approximately 2 weeks and continued as home exercises ranging from 12 to 24 weeks. Physical fatigue, pain, and bone density improved significantly with exercise training for the studied individual participants with spine metastasis and good performance status. No adverse events were reported in any study including during the study period. CONCLUSIONS: Appropriately administered and prescribed isometric spinal stabilization exercises appear safe for adults with metastatic spine disease, as no adverse events were reported. Improvements were seen in several measures, such as pain, quality of life, and physical functioning.

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