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Sensorimotor training and whole-body vibration training have the potential to reduce motor and sensory symptoms of chemotherapy-induced peripheral neuropathy—a randomized controlled pilot trial

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Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent and clinically relevant side effect of chemotherapy. The symptoms diminish patients’ quality of life and represent a decisive limiting factor for medical therapy. To date, effective treatment options are lacking. Specific exercise interventions have proven promising to target relevant symptoms. We conducted a prospective, four-armed, randomized, controlled trial, to evaluate the effects of sensorimotor training (SMT) and whole-body vibration training (WBV) on patients with CIPN. Participants (N = 40) were randomized to either one of two intervention groups (SMT N = 10 or WBV N = 10) or oncological control group (N = 10) and matched by gender and age with a healthy control (N = 10). The intervention groups exercised twice a week for 6 weeks. Primary endpoint was the reduction of CIPN-related symptoms (improve peripheral deep sensitivity, Achilles tendon reflex (ASR) and patellar tendon reflex (PSR), light-touch perception, sense of position, and lower leg strength). Secondary endpoints were nerve conduction velocity and amplitude, balance control, quality of life, and CIPN-related pain. Patients exercising improved sensory and associated motor symptoms. Significant intergroup differences were found for the tendon reflexes (ASR P = .017 and PSR P = .020), peripheral deep sensitivity (P = .010), and pain (P = .043). Furthermore, tendencies were found regarding the subjective improvement of symptoms (P = .075) and two subscales of the EORTC-QLQ-C30 questionnaire: pain (P = .054) and dyspnea (P = .054). The results for the SMT group were superior regarding the tendon reflexes, and a tendency regarding the subjective report of symptoms, while WBV was superior regarding pain. SMT and WBV behold a large potential to reduce CIPN-related symptoms and can be considered feasible and safe for patients with CIPN (compliance 97.5%, no adverse events).

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Acknowledgements

We acknowledge the contributions of Julia Rizza and Kathrin May as well as the advisory support of Prof. Wolfgang Potthast and Dr. Angela Höhne regarding the balance assessment. We are furthermore grateful to the patients and especially the healthy matched participants for their support and volunteering.

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Authors and Affiliations

  1. Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Köln, Germany

    Fiona Streckmann, A. Schenk, M. Oberste, A. Heller, A. Schürhörster & W. Bloch

  2. Department of Sport, Exercise and Health, University of Basel, Birsstr. 320B, 4052, Basel, Switzerland

    Fiona Streckmann

  3. Department of Oncology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland

    Fiona Streckmann

  4. Department of Neurology, University Hospital Cologne, Cologne, Germany

    H.C. Lehmann & M. Balke

  5. Department of Oncology, Center for Integrated Oncology, University Hospital Cologne, Cologne, Germany

    T. Elter & F.T. Baumann

Authors
  1. Fiona Streckmann
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  2. H.C. Lehmann
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  3. M. Balke
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  4. A. Schenk
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  5. M. Oberste
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  6. A. Heller
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  7. A. Schürhörster
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  8. T. Elter
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  9. W. Bloch
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  10. F.T. Baumann
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Corresponding author

Correspondence to Fiona Streckmann.

Ethics declarations

Our prospective, single-center, four-armed RCT was approved by the ethics committee of the German Sport University. All patients gave written informed consent in accordance with the Declaration of Helsinki.

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The authors declare that they have no conflicts of interest.

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Relevance/Novelty of manuscript

Chemotherapy-induced peripheral neuropathy (CIPN) is a highly prevalent and clinically relevant side effect of chemotherapy. The symptoms severely diminish patients’ quality of life and represent a decisive limiting factor for medical therapy, consequently affecting the clinical outcome. To date, effective treatment options are lacking. Specific exercise interventions have now proven promising to reduce sensory symptoms of CIPN, revealing a high potential as treatment option, thus impacting supportive therapy in oncology.

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Streckmann, F., Lehmann, H., Balke, M. et al. Sensorimotor training and whole-body vibration training have the potential to reduce motor and sensory symptoms of chemotherapy-induced peripheral neuropathy—a randomized controlled pilot trial. Support Care Cancer 27, 2471–2478 (2019). https://doi.org/10.1007/s00520-018-4531-4

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  • DOI: https://doi.org/10.1007/s00520-018-4531-4

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