J Matt McCrary1, David Goldstein1,2, Carolina X Sandler3,4,5, Benjamin K Barry6,7, Michael Marthick8, Hannah C Timmins9, Tiffany Li9, Lisa Horvath8,10,11, Peter Grimison8,10,11, Susanna B Park12,13. 1. Prince of Wales Clinical School, University of New South Wales, Kensington, Australia. 2. Prince of Wales Hospital, Randwick, Australia. 3. Cancer Prevention Research Centre, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia. 4. Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, Australia. 5. The Kirby Institute, University of New South Wales, Kensington, Australia. 6. School of Medical Sciences, University of New South Wales, Kensington, Australia. 7. School of Clinical Medicine, The University of Queensland, Brisbane, Australia. 8. The Chris O'Brien Lifehouse, Camperdown, Australia. 9. Brain and Mind Centre, The University of Sydney, Camperdown, NSW, 2050, Australia. 10. Royal Prince Alfred Hospital, Camperdown, Australia. 11. School of Medicine, The University of Sydney, Camperdown, Australia. 12. Prince of Wales Clinical School, University of New South Wales, Kensington, Australia. susanna.park@sydney.edu.au. 13. Brain and Mind Centre, The University of Sydney, Camperdown, NSW, 2050, Australia. susanna.park@sydney.edu.au.
Abstract
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.
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.
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