Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Köln, Germany.
Department of Sport, Exercise and Health, University of Basel, Birsstr. 320B, 4052, Basel, Switzerland.
Support Care Cancer. 2019 Jul;27(7):2471-2478. doi: 10.1007/s00520-018-4531-4. Epub 2018 Oct 31.
Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent and clinically relevant side effect of chemotherapy. The symptoms diminish patients' quality of life and represent a decisive limiting factor for medical therapy. To date, effective treatment options are lacking. Specific exercise interventions have proven promising to target relevant symptoms. We conducted a prospective, four-armed, randomized, controlled trial, to evaluate the effects of sensorimotor training (SMT) and whole-body vibration training (WBV) on patients with CIPN. Participants (N = 40) were randomized to either one of two intervention groups (SMT N = 10 or WBV N = 10) or oncological control group (N = 10) and matched by gender and age with a healthy control (N = 10). The intervention groups exercised twice a week for 6 weeks. Primary endpoint was the reduction of CIPN-related symptoms (improve peripheral deep sensitivity, Achilles tendon reflex (ASR) and patellar tendon reflex (PSR), light-touch perception, sense of position, and lower leg strength). Secondary endpoints were nerve conduction velocity and amplitude, balance control, quality of life, and CIPN-related pain. Patients exercising improved sensory and associated motor symptoms. Significant intergroup differences were found for the tendon reflexes (ASR P = .017 and PSR P = .020), peripheral deep sensitivity (P = .010), and pain (P = .043). Furthermore, tendencies were found regarding the subjective improvement of symptoms (P = .075) and two subscales of the EORTC-QLQ-C30 questionnaire: pain (P = .054) and dyspnea (P = .054). The results for the SMT group were superior regarding the tendon reflexes, and a tendency regarding the subjective report of symptoms, while WBV was superior regarding pain. SMT and WBV behold a large potential to reduce CIPN-related symptoms and can be considered feasible and safe for patients with CIPN (compliance 97.5%, no adverse events).Registration: DRKS00013027.
化疗引起的周围神经病(CIPN)是化疗的一种普遍且具有临床意义的副作用。症状降低了患者的生活质量,成为医学治疗的决定性限制因素。迄今为止,有效的治疗选择仍然缺乏。特定的运动干预措施已被证明对相关症状有积极作用。我们进行了一项前瞻性、四臂、随机、对照试验,以评估感觉运动训练(SMT)和全身振动训练(WBV)对 CIPN 患者的影响。参与者(N=40)被随机分为两组干预组(SMT N=10 或 WBV N=10)或肿瘤对照组(N=10),并按性别和年龄与健康对照组(N=10)相匹配。干预组每周锻炼两次,持续 6 周。主要终点是减少 CIPN 相关症状(改善周围深部感觉、跟腱反射(ASR)和髌腱反射(PSR)、轻触觉、位置感和小腿力量)。次要终点是神经传导速度和幅度、平衡控制、生活质量和 CIPN 相关疼痛。锻炼的患者改善了感觉和相关运动症状。在腱反射(ASR P=0.017 和 PSR P=0.020)、周围深部感觉(P=0.010)和疼痛(P=0.043)方面发现了显著的组间差异。此外,在症状的主观改善(P=0.075)和 EORTC-QLQ-C30 问卷的两个子量表(疼痛 P=0.054 和呼吸困难 P=0.054)方面也出现了趋势。SMT 组在腱反射方面的结果更好,而在症状的主观报告方面存在趋势,而 WBV 在疼痛方面更具优势。SMT 和 WBV 具有减轻 CIPN 相关症状的巨大潜力,可以被认为是 CIPN 患者可行且安全的治疗方法(依从性 97.5%,无不良事件)。注册:DRKS00013027。