BACKGROUND AND AIM: Osteosarcoma (OS) is one of the most common bone cancers that constantly affect children, teenagers, and young adults. The limitation of the effectiveness of current treatments of this disease has been confirmed. Rehabilitation exercises are one of the methods that are said to have a good effect, but there are few studies about this. Osteosarcoma is a malignant bone tumor that arises from primary bone - forming cells, and the production of malignant bone material is its prominent histological sign. The purpose of this study was to investigate the effects of combining rehabilitation exercises with vitamin D consumption on the serum level of osteocalcin, insulin resistance, and the function of pancreatic beta cells in patients with osteosarcoma cancer after bone marrow stem cell transplantation. METHODS: This study was experimental. Forty female patients with osteosarcoma cancer with a body mass index above 30 kg/m2, age 24.9 +/- 4.03 years, height 163.8 +/- 3.6 cm, and weight 82.1 +/- 4.5 kg were the research subjects. The subjects were randomly divided into four groups (control) (patient - exercise), (patient - exercise - placebo) and (patientexercise - vitamin D). The training protocol included ten weeks of Pilate's sports activity, three sessions per week (30 sessions). The weekly supplement group consumed 500 IU of vitamin D for 10 weeks. Data were analyzed using dependent t-test and covariance analysis of variance (p = 0.05). RESULTS: Rehabilitation exercises combined with vitamin D consumption caused a significant increase in osteocalcin in control groups (23.7 +/- 3.5), patient - exercise (26 +/- 14.4), patient - exercise - placebo (26.6 +/- 14.1). And patient - exercise - vitamin D (26.4 +/- 23.1) and a significant decrease in blood glucose of control groups (82.1 +/- 29.9), patient - exercise (72 +/- 0.49), patient - exercise - placebo (71 +/- 1.32) and patient - exercise - vitamin D (71.5 +/- 22.8) of people with osteosarcoma cancer after bone marrow stem cell transplantation. Covariance analysis of the findings of this research showed that rehabilitation exercises along with vitamin D intake caused a non-significant increase in insulin sensitivity in the control groups (36.3 +/- 63.4), patient- exercise (37.2 +/- 11.2), patient - exercise - placebo (37 +/- 2.22) and patient - exercise - vitamin D (37 +/- 12.1) and pancreatic beta cell function of control groups (1.5 +/- 1.1), patient - exercise (1.1 +/- 1.9), patient - exercise - placebo (1.6 +/- 1.77) and patient - exercise - vitamin D (1.9 +/- 3.2). Also, ten sessions of rehabilitation exercises with vitamin D consumption caused a non-significant decrease in insulin resistance in the control groups (1.2 +/- 56.7), patient-exercise (1.7 +/- 45.1), Patient-exercise-placebo (12.2 +/- 1.3) and patient - exercise - vitamin D (33.3 +/- 1.1). CONCLUSION: The findings of this research showed that ten weeks of rehabilitation exercises combined with vitamin D intake caused a significant increase in osteocalcin and insulin and a significant decrease in blood glucose in patients with osteosarcoma cancer.

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