J Matt McCrary1, David Goldstein1,2, David Wyld3,4, Robert Henderson3,4, Craig R Lewis1,2, Susanna B Park5,6. 1. Prince of Wales Clinical School, University of New South Wales, Kensington, Australia. 2. Prince of Wales Hospital, Randwick, Australia. 3. Royal Brisbane and Women's Hospital, Brisbane, Australia. 4. Faculty of Medicine, University of Queensland, Brisbane, Australia. 5. Prince of Wales Clinical School, University of New South Wales, Kensington, Australia. susanna.park@sydney.edu.au. 6. Brain and Mind Centre, The University of Sydney, Camperdown, NSW, 2050, Australia. susanna.park@sydney.edu.au.
Abstract
BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) is a significant and often lasting side effect of cancer treatment, with increasing CIPN severity associated with increasing deficits in balance, gait, and mobility. The 6-min walk test (6MWT) is a widely validated and utilized measure of general physical functioning and mobility, although its utility in a CIPN context is unclear. This study aimed to determine the utility of the 6MWT as an assessment of mobility deficits in a CIPN cohort and utilize the 6MWT to compare mobility data from CIPN patients to those of healthy and clinical populations. METHODS: Cancer survivors exposed to neurotoxic chemotherapies (N = 100; mean 17 ± 13 months post-treatment; mean age 59 ± 13 years) completed a single cross-sectional assessment of patient-reported and objective CIPN, mobility (6MWT), and disability. RESULTS: CIPN symptoms were reported in the majority of the cohort (87%). Increasing age, patient-reported and objective CIPN symptoms, and disability were associated with decreasing 6MWT distance (.48 ≤ R ≤ .63; p < .001) in bivariate models. Multiple regression models of 6MWT distance included age, sex, and patient-reported or objective CIPN severity as significant independent correlates (.62 ≤ R ≤ .64; p < .03). 6MWT distances in patients with CIPN symptom severity above the cohort mean were consistent with mean values reported in diabetic neuropathy and clinical populations. CONCLUSIONS: Increased CIPN symptoms are associated with increased mobility deficits. The 6MWT demonstrates promising utility as a mobility assessment in a CIPN cohort. IMPLICATIONS FOR CANCER SURVIVORS: The impact of the progression of CIPN on mobility deficits in survivors emphasizes the need for effective interventions to treat and prevent CIPN.
BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) is a significant and often lasting side effect of cancer treatment, with increasing CIPN severity associated with increasing deficits in balance, gait, and mobility. The 6-min walk test (6MWT) is a widely validated and utilized measure of general physical functioning and mobility, although its utility in a CIPN context is unclear. This study aimed to determine the utility of the 6MWT as an assessment of mobility deficits in a CIPN cohort and utilize the 6MWT to compare mobility data from CIPN patients to those of healthy and clinical populations. METHODS:Cancer survivors exposed to neurotoxic chemotherapies (N = 100; mean 17 ± 13 months post-treatment; mean age 59 ± 13 years) completed a single cross-sectional assessment of patient-reported and objective CIPN, mobility (6MWT), and disability. RESULTS:CIPN symptoms were reported in the majority of the cohort (87%). Increasing age, patient-reported and objective CIPN symptoms, and disability were associated with decreasing 6MWT distance (.48 ≤ R ≤ .63; p < .001) in bivariate models. Multiple regression models of 6MWT distance included age, sex, and patient-reported or objective CIPN severity as significant independent correlates (.62 ≤ R ≤ .64; p < .03). 6MWT distances in patients with CIPN symptom severity above the cohort mean were consistent with mean values reported in diabetic neuropathy and clinical populations. CONCLUSIONS: Increased CIPN symptoms are associated with increased mobility deficits. The 6MWT demonstrates promising utility as a mobility assessment in a CIPN cohort. IMPLICATIONS FOR CANCER SURVIVORS: The impact of the progression of CIPN on mobility deficits in survivors emphasizes the need for effective interventions to treat and prevent CIPN.
Authors: T J Postma; N K Aaronson; J J Heimans; M J Muller; J G Hildebrand; J Y Delattre; K Hoang-Xuan; M Lantéri-Minet; R Grant; R Huddart; C Moynihan; J Maher; R Lucey Journal: Eur J Cancer Date: 2005-04-14 Impact factor: 9.162