Supportive Care in Cancer

, Volume 26, Issue 2, pp 615–624 | Cite as

Eight-week, multimodal exercise counteracts a progress of chemotherapy-induced peripheral neuropathy and improves balance and strength in metastasized colorectal cancer patients: a randomized controlled trial

  • Philipp ZimmerEmail author
  • Sina Trebing
  • Ursula Timmers-Trebing
  • Alexander Schenk
  • Rainer Paust
  • Wilhelm Bloch
  • Roland Rudolph
  • Fiona Streckmann
  • Freerk T. Baumann
Original Article



Physical activity is supposed to decrease mortality of colorectal cancer (CRC) and is suggested to reduce side-effects of the disease and its treatment. However, the knowledge about the influence of exercise interventions on patients suffering from CRC and metastasized CRC (mCRC) is still sparse. One frequently observed side effect in mCRC is chemotherapy-induced peripheral neuropathy (CIPN). This randomized controlled trial investigated the influence of a supervised exercise program on CIPN in mCRC.


Thirty patients (stage IV) undergoing outpatient palliative treatment including a median of 23.5 chemotherapy cycles of various regimens were randomly assigned to an intervention or control group (IG, n = 17; CG, n = 13). The IG participated in an eight-week supervised exercise program, including endurance, resistance and balance training (2×/week for 60 min) whereas the CG received written standard recommendations to obtain physical fitness. CIPN was assessed using the FACT/GOG-NTX questionnaire. Moreover, endurance capacity (6MWT), strength (h1RM) and balance (GGT-Reha) were evaluated before (t 0) and after (t 1) the intervention as well as after 4 weeks follow-up (t2).


Neuropathic symptoms remained stable in the IG over time, while CIPN significantly worsened in the CG from t 0 to t 1 and t 0 to t 2. In contrast to the CG, the IG significantly improved in strength and balance function. Changes in CIPN correlated with changes in balance.


This is the first investigation showing positive effects of a multimodal exercise program on CIPN, balance and strength on mCRC patients in a palliative setting, thereby consequently increasing patients` quality of life. The results support earlier findings stating a positive influence of balance exercise on CIPN.


Exercise CIPN Balance Advanced colorectal cancer 



We would like to thank all patients who participated in this clinical trial and all physicians and hospitals who supported recruitment, especially C. Müller, dpt. for internal oncology and hematology, Essen-Mitte Clinics.

The intervention was supported by Novitas BKK and AOK Rheinland/Hamburg.

Compliance with ethical standards

Conflict of interest

None declared.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Philipp Zimmer
    • 1
    • 2
    Email author
  • Sina Trebing
    • 1
  • Ursula Timmers-Trebing
    • 3
  • Alexander Schenk
    • 1
  • Rainer Paust
    • 4
  • Wilhelm Bloch
    • 1
  • Roland Rudolph
    • 5
  • Fiona Streckmann
    • 1
    • 6
    • 7
  • Freerk T. Baumann
    • 8
  1. 1.Department for Molecular and Cellular Sports MedicineGerman Sports University CologneCologneGermany
  2. 2.Department for Physical Activity, Preventive Research and CancerGerman Cancer Research CenterHeidelbergGermany
  3. 3.VGSU EssenAssociation for Health Related Fitness and Sports Therapy at University Duisburg-EssenEssenGermany
  4. 4.Contilia GroupInstitute for Psychosocial MedicineEssenGermany
  5. 5.Outpatient Tumor Centre EssenEssenGermany
  6. 6.Department of Sport, Exercise and HealthUniversity of BaselBaselSwitzerland
  7. 7.Department of Medical OncologyUniversity Hospital of BaselBaselSwitzerland
  8. 8.Department I of Internal Medicine, Center for Integrated Oncology Cologne BonnUniversity Hospital of CologneCologneGermany

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