An Exploratory Randomized Trial of Physical Therapy for the Treatment of Chemotherapy-Induced Peripheral Neuropathy

Hammond, Elizabeth; Pitz, Marshall; Steinfeld, Karen; Lambert, Pascal; Shay, Barbara

doi:10.1177/1545968319899918

Cited by 47 publications

(68 citation statements)

References 55 publications

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“…A combination of PROMs and physician grading score was used in one study [50]. The majority of the more recent studies used a combination of validated PROMs and Quantitative Sensory Testing [58,[62][63][64][65].…”

Section: Exercise Studiesmentioning

confidence: 99%

“…Frequency per week: daily 55,57,62 , twice a week 50,61,65,66,68,69 , three mes per week 63 , five days per week 56,60,64 Length per session: 10-60 minutes (range); 41 minutes (average)…”

Section: Durmentioning

confidence: 99%

“…Use of mechanical aids and environmental support: therapeu bands 55,60,63,66,68 , pedometer 60 , exercise-tracking website 60 , postural devices 61 , treadmill 64 , sta onary bicycle 63,65 , free weights 64 , in ve sensor screen 63 , balance pads 69 , cherry pit pillows 69 , cross-trainer 69 , cycle ergometer 64,69 , ellip al trainer 64 , exercise mats 64…”

Section: Durmentioning

confidence: 99%

“…Timing of interven n: during treatment 55, 56, 66, 69 during and a treatment [60][61][62] , treatment 50,63,65,68 Intensity of exercise: low 66 , moderate 46,51,52,65 , determined by ra ng or perceived exe on 63 , determined by chemotherapy protocol 64…”

Section: Exercise Interven Ons For Cipn Preven On and Managementmentioning

confidence: 99%

“…-Combined aerobic and muscle strength/power 55,60 -Combined aerobic and balance 65,66 -Combined muscle strength/power and balance 50,…”

Section: Components: Exercise Activitiesmentioning

confidence: 99%

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A systematic review of behavioural and exercise interventions for the prevention and management of chemotherapy-induced peripheral neuropathy symptoms

et al. 2021

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Background Chemotherapy-induced peripheral neuropathy (CIPN) can result in functional difficulties. Pharmacological interventions used to prevent CIPN either show low efficacy or lack evidence to support their use and to date, duloxetine remains the only recommended treatment for painful CIPN. Non-pharmacological interventions such as exercise and behavioural interventions for CIPN exist. Purpose The aims were to (1) identify and appraise evidence on existing behavioural and exercise interventions focussed on preventing or managing CIPN symptoms, (2) describe psychological mechanisms of action by which interventions influenced CIPN symptoms, (3) determine the underpinning conceptual models that describe how an intervention may create behaviour change, (4) identify treatment components of each intervention and contextual factors, (5) determine the nature and extent of patient and clinician involvement in developing existing interventions and (6) summarise the relative efficacy or effectiveness of interventions to lessen CIPN symptoms and to improve quality of life, balance and muscle strength. Methods A systematic search of Ovid Medline, Cochrane Library, EMBASE, PsycINFO, Health Management Information Consortium, Global Health and CINAHL was performed to identify articles published between January 2000 to May 2020, followed by OpenGrey search and hand-searching of relevant journals. Studies that explored behavioural and/or exercise interventions designed to prevent or improve symptoms of CIPN in adults who had received or were receiving neurotoxic chemotherapy for any type of cancer, irrespective of when delivered within the cancer pathway were included. Results Nineteen randomised controlled trials and quasi-experimental studies which explored behavioural (n=6) and exercise (n=13) interventions were included. Four studies were rated as methodologically strong, ten were moderate and five were weak. Ten exercise and two behavioural interventions, including those that improved CIPN knowledge and self-management resources and facilitated symptom self-reporting, led to reduced CIPN symptoms during and/or after chemotherapy treatment. Conclusions The extent of potential benefits from the interventions was difficult to judge, due to study limitations. Future interventions should incorporate a clear theoretical framework and involve patients and clinicians in the development process. Implications for Cancer Survivors Our findings show exercise interventions have beneficial effects on CIPN symptoms although higher quality research is warranted. Behavioural interventions that increase patient’s CIPN knowledge, improve self-management capacity and enable timely access to symptom management led to reduced CIPN symptoms.

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Section: Exercise Studiesmentioning

confidence: 99%

“…Frequency per week: daily 55,57,62 , twice a week 50,61,65,66,68,69 , three mes per week 63 , five days per week 56,60,64 Length per session: 10-60 minutes (range); 41 minutes (average)…”

Section: Durmentioning

confidence: 99%

Section: Durmentioning

confidence: 99%

Section: Exercise Interven Ons For Cipn Preven On and Managementmentioning

confidence: 99%

“…-Combined aerobic and muscle strength/power 55,60 -Combined aerobic and balance 65,66 -Combined muscle strength/power and balance 50,…”

Section: Components: Exercise Activitiesmentioning

confidence: 99%

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A systematic review of behavioural and exercise interventions for the prevention and management of chemotherapy-induced peripheral neuropathy symptoms

et al. 2021

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Effect of Exercise on Chemotherapy-Induced Peripheral Neuropathy Among Patients Treated for Ovarian Cancer

Cao

Cartmel

et al. 2023

JAMA Netw Open

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ImportanceChemotherapy-induced peripheral neuropathy (CIPN), one of the most common and severe adverse effects of chemotherapy, is associated with worse quality of life among survivors of ovarian cancer. Currently, there is no effective treatment for CIPN.ObjectiveTo evaluate the effect of a 6-month aerobic exercise intervention vs attention-control on CIPN among women treated for ovarian cancer in the Women’s Activity and Lifestyle Study in Connecticut (WALC) to provide evidence to inform the guidelines and recommendations for prevention or treatment of CIPN.Design, Setting, and ParticipantsThis prespecified secondary analysis evaluated the Women’s Activity and Lifestyle Study in Connecticut (WALC), a multicentered, open-label, population-based, phase 3 randomized clinical trial of an aerobic exercise intervention vs attention control for CIPN in patients who were diagnosed with ovarian cancer. Only WALC participants who received chemotherapy were included in this analysis. Participants were randomized 1:1 to either a 6-month aerobic exercise intervention or to attention control. All analyses were conducted between September 2022 and January 2023.InterventionsThe exercise intervention consisted of home-based moderate-intensity aerobic exercise facilitated by weekly telephone counseling from an American College of Sports Medicine/American Cancer Society–certified cancer exercise trainer. Attention control involved weekly health education telephone calls from a WALC staff member.Main Outcomes and MeasureChange in CIPN was the primary outcome in this secondary analysis. This outcome was represented by CIPN severity, which was self-measured by participants at baseline and 6 months using the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group–Neurotoxicity scale, with a score range of 0 to 44. A mixed-effects model was used to assess the 6-month change in CIPN between the exercise intervention and attention control arms.ResultsOf the 134 participants (all females; mean [SD] age, 57.5 [8.3] years) included in the analysis, 69 were in the exercise intervention arm and 65 were in the attention control arm. The mean (SD) time since diagnosis was 1.7 (1.0) years. The mean (SD) baseline CIPN scores were 8.1 (5.6) in the exercise intervention arm and 8.8 (7.9) in the attention control arm (P = .56). At 6 months, the self-reported CIPN score was reduced by 1.3 (95% CI, −2.3 to −0.2) points in the exercise intervention arm compared with an increase of 0.4 (95% CI, −0.8 to 1.5) points in the attention control arm. The between-group difference was −1.6 (95% CI, −3.1 to −0.2) points. The point estimate was larger among the 127 patients with CIPN symptoms at enrollment (−2.0; 95% CI, −3.6 to −0.5 points).Conclusions and RelevanceFindings of this secondary analysis of the WALC trial indicate that a 6-month aerobic exercise intervention vs attention control significantly improved self-reported CIPN among patients who were treated for ovarian cancer. While replication of the findings in other studies is warranted, incorporating referrals to exercise programs into standard oncology care could reduce CIPN symptoms and increase quality of life in patients with ovarian cancer.Trial RegistrationClinicalTrials.gov Identifier: NCT02107066

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Systematic Review of Exercise for Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy

Kleckner

Park

Streckmann

et al. 2021

Diagnosis, Management and Emerging Strategies for Chemotherapy-Induced Neuropathy

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An Exploratory Randomized Trial of Physical Therapy for the Treatment of Chemotherapy-Induced Peripheral Neuropathy

Cited by 47 publications

References 55 publications

A systematic review of behavioural and exercise interventions for the prevention and management of chemotherapy-induced peripheral neuropathy symptoms

A systematic review of behavioural and exercise interventions for the prevention and management of chemotherapy-induced peripheral neuropathy symptoms

Effect of Exercise on Chemotherapy-Induced Peripheral Neuropathy Among Patients Treated for Ovarian Cancer

Systematic Review of Exercise for Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy

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