Exercise-based rehabilitation for cancer survivors with chemotherapy-induced peripheral neuropathy.
PURPOSE
Chemotherapy-induced peripheral neuropathy (CIPN) affects up to 40% of cancer survivors and is associated with functional deficits and an increased falls incidence. There are presently no strongly recommended treatment strategies for CIPN. The aim of this study was to evaluate the impact of a multimodal exercise intervention on CIPN symptoms and related functional deficits, as well as neurophysiologic parameters.


METHODS
All outcomes were assessed before and after an 8-week exercise intervention (3-weekly sessions) and preceding 8-week control period at baseline, pre-exercise and post-exercise. Outcome measures were objective and patient-reported CIPN, standing and dynamic balance, mobility, quality of life, and sensory and motor nerve excitability and conduction studies.


RESULTS
Twenty-nine cancer survivors (8 male, 21 female; mean age 61.6 ± 11.8 years) with CIPN symptoms affecting function completed all assessments. Objective and patient-reported CIPN, dynamic balance, standing balance in eyes open conditions, mobility and quality of life were improved from pre- to post-exercise (4.0 < F < 10.2; p < .05), with no changes over the control period (p > .21). No changes were observed in sensory or motor neurophysiologic parameters (p > .23).


CONCLUSIONS
This study provides encouraging evidence of the rehabilitative potential of multimodal exercise for persisting CIPN in a post-treatment cohort. Large randomised controlled trials are justified to confirm observed benefits and determine the mechanisms and clinical significance.
['McCrary|J Matt|JM|', 'Goldstein|David|D|', 'Sandler|Carolina X|CX|', 'Barry|Benjamin K|BK|', 'Marthick|Michael|M|', 'Timmins|Hannah C|HC|', 'Li|Tiffany|T|', 'Horvath|Lisa|L|', 'Grimison|Peter|P|', 'Park|Susanna B|SB|']
D000328:Adult D000368:Aged D000970:Antineoplastic Agents D000073116:Cancer Survivors D015331:Cohort Studies D015444:Exercise D005081:Exercise Therapy D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009369:Neoplasms D017063:Outcome Assessment, Health Care D000077150:Oxaliplatin D017239:Paclitaxel D010523:Peripheral Nervous System Diseases D011788:Quality of Life
Neurophysiology Aerobic training Balance training Resistance training Survivorship