A randomized exploratory phase 2 study in patients with chemotherapy-related peripheral neuropathy evaluating whole-body vibration training as adjunct to an integrated program including massage, passive mobilization and physical exercises

Abstract

BackgroundChemotherapy-induced polyneuropathy (CIPN) is a common toxicity after chemotherapy, immunomodulatory drugs or proteasome inhibitors, which is difficult to treat and may also have impact on quality of life. The objective of the study was to evaluate whole-body vibration (WBV) on the background of an integrated program (IP) including massage, passive mobilization and physical exercises on CIPN.Patients and methodsIn an exploratory phase-2 study patients with CIPN (NCI CTC grade 2/3) were randomized for WBV plus IP (experimental) to IP alone (standard). 15 training sessions within 15 weeks were intended. As primary endpoint we used chair-rising test (CRT) to assess physical fitness and coordination. In addition, locomotor and neurological tests and self-assessment tools were performed.ResultsA total 131 patients with CIPN were randomized (standard, n = 65; experimental, n = 66). The median age was 60 (range 24–71) years; 44 patients had haematological neoplasms and 87 solid tumors. At baseline, all patients presented with an abnormal CRT. Fifteen (standard) and 22 (experimental) patients left the program due to progression/relapse or concomitant disease. There was no significant difference in the proportion of patients with normal CRT (<10 s) at follow up between experimental (68%) and standard (56%) (p = 0.20). All patients experienced less symptoms and pain (p < 0.001) and had improved CRT (p < 0.001) over time. WBV was significantly associated with a higher reduction of time needed for CRT (p = 0.02) and significantly improved warm-detection-threshold comparing baseline to follow-up assessment (p = 0.02).ConclusionWhole-body vibration on the background of an IP may improve physical fitness and coordination in patients suffering from CIPN. Trial registration Retrospectively registered at http://www.iscrtn.com (ISRCTN 51361937) and http://www.clinicaltrials.gov (NCT02846844).Electronic supplementary materialThe online version of this article (doi:10.1186/s40164-017-0065-6) contains supplementary material, which is available to authorized users.

Oncological Rehabilitation

“…These data suggest the need for diagnosing the mental impacts of a tumor disease and tumor therapy, and for creating appropriate therapeutic offers [25]. There are recent evidence-based treatment approaches even for difficult-to-treat long-term function disorders, such as CIPN and cognitive dysfunction [26,27,28,29]. …”

Prevention and Management of Chemotherapy-Induced Polyneuropathy

“…Owing to this fact, there is a lack of strong scientific evidence about its specific usefulness in the treatment of CIPN. Nevertheless, the number of studies showing the effectiveness of physical exercise and functional training (e.g., vibration training) is increasing [32, 33]. To improve coordination, sensorimotor function, and fine motor function the training should begin with the onset of manifest CIPN at the latest.…”

Evidence Based Complementary Approaches in the Management of Chemotherapy-Induced Peripheral Neuropathy in Cancer Patients

“…Çalışma sonucunda, her iki grupta da nöropati semptomlarında azalma ve duyusal fonksiyonlarda iyileşme olduğu saptanmıştır. (33)…”

“…Değerlendirme neticesinde her iki grupta da nöropati semptomlarında ve duyusal fonksiyonlarda iyileşme belirlenmiştir. (33) Zimmer ve arkadaşları yaptıkları randomize kontrollü çalışmada metastatik kolorektal kanser tanılı hastalarda gelişen periferal nöropatide multimodal egzersiz, denge ve kuvvet geliştirmenin etkisini değerlendirmiştir. Deney grubuna 8 hafta boyunca egzersiz programı (dayanıklılık, denge direnç antremanı) haftada 2 kez 60 dk olacak şekilde uygulanırken, kontrol grubuna da kliniğin standart protokolü uygulanmıştır.…”