Impaired Postural Control and Altered Sensory Organization During Quiet Stance Following Neurotoxic Chemotherapy: A Preliminary Study

Monfort, Scott M.; Pan, Xueliang; Loprinzi, Charles L.; Lustberg, Maryam B.; Chaudhari, Ajit M.W.

doi:10.1177/1534735419828823

Cited by 33 publications

(45 citation statements)

References 29 publications

(71 reference statements)

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“…People with PN demonstrate increased sway with their eyes closed and more sway response to visual flow. 10,11 Decreased use of an ankle strategy is also noted as is decreased reaction time which both can increase the risk of falling 12 .…”

Section: Background and Purposementioning

confidence: 99%

Long-term Use of a Sensory Neuroprosthesis Improves Function in a Patient with Peripheral Neuropathy: a Case Report

Wrisley¹,

McLean²,

Hill³

et al. 2020

Preprint

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Background:Peripheral neuropathy (PN) can result in either partial or complete loss of distal sensation resulting in an increased fall risk. Walkasins® uses a shoe insert to detect the magnitude and direction of sway and sends signals to a leg unit that provides sensory balance cues. The objective of this case report is to describe the long-term influence of the Walkasins® lower limb sensory neuroprosthesis on balance and gait for an individual with diabetic PN.Case Description:A fifty-one-year-old male with a 3-year history of PN and a 10-year history of type II diabetes mellitus was fitted with Walkasins® and utilized the shoe inserts 8-10 hours/day for more than 1 year. Although, vibration and tactile thresholds were severely impaired at his 1st metatarsophalangeal joint and the lateral malleolus bilaterally he could perceive tactile stimuli from the Walkasins® above the ankles.Outcomes:Following Walkasins® use, his Activities-specific Balance Confidence Scale (ABC) scores improved from 33% to 80%. His mean Vestibular Activities of Daily Living (VADL) scores decreased from 3.54 to 1. His Functional Gait Assessment (FGA) scores increased from 13/30 to 28/30 and his miniBESTest scores improved from 15/28 to 26/28. Gait speed increased from 0.23 m/sec to 1.5 m/sec. The patient described a decrease in pain and cramping throughout his lower extremities and an increase in function.Discussion:Gait and balance improved with the use of the Walkasins® and participation in the Neuro Wellness Program. This improvement suggests that the use of sensory substitution devices, such as the Walkasins®, may replace sensory deficits related to gait and balance dysfunction experienced by patients with PN. Further research is needed to determine if other patients will have a similar response and what the necessary threshold of sensory function is to benefit from use of the Walkasins®.

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Section: Background and Purposementioning

confidence: 99%

Long-term Use of a Sensory Neuroprosthesis Improves Function in a Patient with Peripheral Neuropathy: a Case Report

Wrisley¹,

McLean²,

Hill³

et al. 2020

Preprint

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“…Sway amplitude, including the root mean square (RMS) of the resultant sway [ 30 ], the mediolateral (ML) sway [ 25 , 29 ], and the total sway area [ 25 , 26 , 28 ] were greater in cancer survivors than healthy controls. Sway velocity, including the mean velocity of ML sway [ 25 , 28 ] and mean velocity of the resultant sway [ 24 ] were also greater in cancer survivors than that in controls. Three studies (the majority of participants had breast cancer) [ 31 – 33 ] assessed the longitudinal effect of chemotherapy on spontaneous sway and found that sway amplitude (area, ML RMS, AP RMS) and sway velocity (AP mean velocity, ML mean velocity) parameters worsen after treatment.…”

Section: Resultsmentioning

confidence: 99%

A review of movement disorders in chemotherapy-induced neurotoxicity

Wang

Housley

Flores

et al. 2021

J NeuroEngineering Rehabil

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Chemotherapy agents used in the standard treatments for many types of cancer are neurotoxic and can lead to lasting sensory and motor symptoms that compromise day-to-day movement functions in cancer survivors. To date, the details of movement disorders associated with chemotherapy are known largely through self-reported symptoms and functional limitations. There are few quantitative studies of specific movement deficits, limiting our understanding of dysfunction, as well as effective assessments and interventions. The aim of this narrative review is to consolidate the current understanding of sensorimotor disabilities based on quantitative measures in cancer survivors who received chemotherapy. We performed literature searches on PubMed and found 32 relevant movement studies. We categorized these studies into three themes based on the movement deficits investigated: (1) balance and postural control; (2) gait function; (3) upper limb function. This literature suggests that cancer survivors have increased postural sway, more conservative gait patterns, and suboptimal hand function compared to healthy individuals. More studies are needed that use objective measures of sensorimotor function to better characterize movement disabilities and investigate the underlying causes, as required for developing targeted assessments and interventions. By updating our understanding of movement impairments in this population, we identify significant gaps in knowledge that will help guide the direction of future research.

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“…taxanes. Patients display deficits in the spatiotemporal parameters (speed and stride) of walking gait, in control of posture, and in balance relying on proprioception 49,50 . Acknowledging that these disabilities may arise from a variety of lesions in the nervous system, the deficits we observe here in the initial detection and encoding of muscle mechanics would necessarily impair movements and postures and cannot be fully compensated by other senses, e.g.…”

Section: Discussionmentioning

confidence: 99%

Cancer Exacerbates Chemotherapy Induced Sensory Neuropathy

Housley

Nardelli

Carrasco

et al. 2019

Preprint

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AbstractFor the constellation of neurological disorders known as chemotherapy induced peripheral neuropathy, mechanistic understanding, and treatment remain deficient. Here we present the first evidence in preclinical investigation of rats that chronic sensory neuropathy depends on non-linear interactions between cancer and chemotherapy. Global transcriptional profiling of dorsal root ganglia revealed differential expression, notably in regulators of neuronal excitability, metabolism and inflammatory responses, all of which were unpredictable from effects observed with either chemotherapy or cancer alone. Systemic interactions between cancer and chemotherapy also determined the extent of deficits in sensory encoding and ion channel protein expression by single mechanosensory neurons, with the potassium ion channel Kv3.3 emerging as a potential contributor to sensory neuron dysfunction. These original findings identify novel contributors to peripheral neuropathy, and emphasize the fundamental dependence of neuropathy on the systemic interaction between chemotherapy and cancer.

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Impaired Postural Control and Altered Sensory Organization During Quiet Stance Following Neurotoxic Chemotherapy: A Preliminary Study

Cited by 33 publications

References 29 publications

Long-term Use of a Sensory Neuroprosthesis Improves Function in a Patient with Peripheral Neuropathy: a Case Report

Long-term Use of a Sensory Neuroprosthesis Improves Function in a Patient with Peripheral Neuropathy: a Case Report

A review of movement disorders in chemotherapy-induced neurotoxicity

Cancer Exacerbates Chemotherapy Induced Sensory Neuropathy

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