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

Kleckner, Ian R.; Park, Susanna B.; Streckmann, Fiona; Wiskemann, Joachim; Hardy, Sara; Mohile, Nimish

doi:10.1007/978-3-030-78663-2_8

Cited by 12 publications

(18 citation statements)

References 127 publications

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“…These mechanisms work synergistically at molecular, subcellular, cellular, and neural levels to improve peripheral nerve function, as shown by studies modeling traumatic peripheral nerve injury with humans and mice [ 27 ]. Although experimental data specifically relating to mechanisms of exercise-induced benefit on CIPN is limited, the key mechanisms underlying the effects of exercise on peripheral nerve function more generally are likely applicable to CIPN [ 15 ].…”

Section: Neurophysiological Mechanismsmentioning

confidence: 99%

“…Although exercise is not currently recommended in clinical guidelines to treat CIPN due to lack of definitive phase III clinical trials, there are approximately two dozen published clinical trials of exercise and CIPN; about a dozen randomized controlled trials, the majority of which suggest its efficacy [ 15 ]; and a recent meta-analysis estimating small-to-medium beneficial effects [ 18 ]. It is plausible that exercise will soon be shown to be beneficial for CIPN.…”

Section: Summary and Future Workmentioning

confidence: 99%

“…Despite over 20 years of research and over 100 clinical trials [ 12 , 13 ], duloxetine is the only intervention recommended to treat CIPN. Amid highly limited medication-based treatment options, exercise has emerged as a promising and safe intervention for CIPN, as suggested by approximately two dozen randomized and non-randomized clinical trials to date [ 14 , 15 , 16 ]. This is in line with a large body of research suggesting that exercise improves other common cancer-related health outcomes, including fatigue, anxiety, depression, physical functioning, and health-related quality of life [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, a recent meta-analysis across seven RCTs found that in patients with cancer at risk for CIPN, exercise yielded beneficial effects on static balance (overall effect size (ES) = 0.46) and neuropathic symptoms (overall ES = 0.43) [ 18 ], reinforcing the promise of exercise for CIPN yet the need for future definitive studies. Research on exercise and CIPN is also a rapidly growing area of research—our recent review found that 12 of the 23 identified studies were published from 2019 to 2021 with 19 more studies preregistered [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, it is likely that exercise will be optimal when prescribed for patients who are prone to benefit, as has been suggested by a recent study where baseline neurophysiological testing predicted both patient postural control profiles and the extent of benefit of balance exercises on CIPN [ 22 ]. Although there is significant evidence suggesting benefits of exercise for CIPN [ 14 , 15 ], the mechanisms of these effects remain unclear, and they are rarely reviewed. Thus, our goal was to prepare the most comprehensive review of potential mechanisms, mediators, moderators, and biomarkers of the effects of exercise on CIPN to date.…”

Section: Introductionmentioning

confidence: 99%

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Mechanisms, Mediators, and Moderators of the Effects of Exercise on Chemotherapy-Induced Peripheral Neuropathy

Chung

Park

Streckmann

et al. 2022

Cancers

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Chemotherapy-induced peripheral neuropathy (CIPN) is an adverse effect of neurotoxic antineoplastic agents commonly used to treat cancer. Patients with CIPN experience debilitating signs and symptoms, such as combinations of tingling, numbness, pain, and cramping in the hands and feet that inhibit their daily function. Among the limited prevention and treatment options for CIPN, exercise has emerged as a promising new intervention that has been investigated in approximately two dozen clinical trials to date. As additional studies test and suggest the efficacy of exercise in treating CIPN, it is becoming more critical to develop mechanistic understanding of the effects of exercise in order to tailor it to best treat CIPN symptoms and identify who will benefit most. To address the current lack of clarity around the effect of exercise on CIPN, we reviewed the key potential mechanisms (e.g., neurophysiological and psychosocial factors), mediators (e.g., anti-inflammatory cytokines, self-efficacy, and social support), and moderators (e.g., age, sex, body mass index, physical fitness, exercise dose, exercise adherence, and timing of exercise) that may illuminate the relationship between exercise and CIPN improvement. Our review is based on the studies that tested the use of exercise for patients with CIPN, patients with other types of neuropathies, and healthy adults. The discussion presented herein may be used to (1) guide oncologists in predicting which symptoms are best targeted by specific exercise programs, (2) enable clinicians to tailor exercise prescriptions to patients based on specific characteristics, and (3) inform future research and biomarkers on the relationship between exercise and CIPN.

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Section: Neurophysiological Mechanismsmentioning

confidence: 99%

Section: Summary and Future Workmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mechanisms, Mediators, and Moderators of the Effects of Exercise on Chemotherapy-Induced Peripheral Neuropathy

Chung

Park

Streckmann

et al. 2022

Cancers

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Updated systematic review of the effects of exercise on understudied health outcomes in cancer survivors

Sturgeon,

Kok,

Kleckner

et al. 2023

Cancer Medicine

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IntroductionThe American College of Sports Medicine provided guidelines for exercise prescriptions in cancer survivors for specific cancer‐ and treatment‐related health outcomes. However, there was insufficient evidence to generate exercise prescriptions for 10 health outcomes of cancer treatment. We sought to update the state of evidence.MethodsWe conducted a systematic review of these 10 understudied health outcomes (bone health, sleep, cardiovascular function, chemotherapy‐induced peripheral neuropathy (CIPN), cognitive function, falls and balance, nausea, pain, sexual function, and treatment tolerance) and provided an update of evidence.ResultsWhile the evidence base for each outcome has increased, there remains insufficient evidence to generate exercise prescriptions. Common limitations observed across outcomes included: variability in type and quality of outcome measurement tools, variability in definitions of the health outcomes, a lack of phase III trials, and a majority of trials investigating breast or prostate cancer survivors only.ConclusionWe identified progress in the field of exercise oncology for several understudied cancer‐ and treatment‐related health outcomes. However, we were not able to generate exercise prescriptions due to continued insufficient evidence base. More work is needed to prescribe exercise as medicine for these understudied health outcomes, and our review highlights several strategies to aid in research acceleration within these areas of exercise oncology.

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Physiotherapy and Rehabilitation in Gynecologic Cancers

Yildiz

2024

Interdisciplinary Cancer Research

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

Cited by 12 publications

References 127 publications

Mechanisms, Mediators, and Moderators of the Effects of Exercise on Chemotherapy-Induced Peripheral Neuropathy

Mechanisms, Mediators, and Moderators of the Effects of Exercise on Chemotherapy-Induced Peripheral Neuropathy

Updated systematic review of the effects of exercise on understudied health outcomes in cancer survivors

Physiotherapy and Rehabilitation in Gynecologic Cancers

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