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Exercise-based rehabilitation for cancer survivors with chemotherapy-induced peripheral neuropathy

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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.

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Funding

This study was supported by a Cancer Institute NSW Program Grant (14/TPG/1-05) and a National Health and Medical Research Council of Australia (NHMRC) Project Grant (no. 1080521). SBP is supported by a NHMRC Career Development Fellowship (no. 1148595).

Author information

Authors and Affiliations

  1. Prince of Wales Clinical School, University of New South Wales, Kensington, Australia

    J. Matt McCrary, David Goldstein & Susanna B. Park

  2. Prince of Wales Hospital, Randwick, Australia

    David Goldstein

  3. Cancer Prevention Research Centre, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia

    Carolina X. Sandler

  4. Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, Australia

    Carolina X. Sandler

  5. The Kirby Institute, University of New South Wales, Kensington, Australia

    Carolina X. Sandler

  6. School of Medical Sciences, University of New South Wales, Kensington, Australia

    Benjamin K. Barry

  7. School of Clinical Medicine, The University of Queensland, Brisbane, Australia

    Benjamin K. Barry

  8. The Chris O’Brien Lifehouse, Camperdown, Australia

    Michael Marthick, Lisa Horvath & Peter Grimison

  9. Brain and Mind Centre, The University of Sydney, Camperdown, NSW, 2050, Australia

    Hannah C. Timmins, Tiffany Li & Susanna B. Park

  10. Royal Prince Alfred Hospital, Camperdown, Australia

    Lisa Horvath & Peter Grimison

  11. School of Medicine, The University of Sydney, Camperdown, Australia

    Lisa Horvath & Peter Grimison

Authors
  1. J. Matt McCrary
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  2. David Goldstein
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  3. Carolina X. Sandler
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  4. Benjamin K. Barry
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  10. Susanna B. Park
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Corresponding author

Correspondence to Susanna B. Park.

Ethics declarations

All participants gave their written consent prior to participation. This study was approved by the South Eastern Sydney Local Health District human ethics committee (no. 15-318), performed in accordance with the Declaration of Helsinki, and prospectively registered with the Australian New Zealand Clinical Trials Registry (Trial ID: ACTRN12616000318482).

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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McCrary, J.M., Goldstein, D., Sandler, C.X. et al. Exercise-based rehabilitation for cancer survivors with chemotherapy-induced peripheral neuropathy. Support Care Cancer 27, 3849–3857 (2019). https://doi.org/10.1007/s00520-019-04680-w

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  • DOI: https://doi.org/10.1007/s00520-019-04680-w

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