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神经毒性化疗后安静站立时姿势控制受损和感觉组织改变:初步研究。

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

机构信息

1 Montana State University, Bozeman, MT, USA.

2 The Ohio State University, Columbus, OH, USA.

出版信息

Integr Cancer Ther. 2019 Jan-Dec;18:1534735419828823. doi: 10.1177/1534735419828823.

DOI:10.1177/1534735419828823
PMID:30741022
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7242799/
Abstract

Individuals diagnosed with chemotherapy-induced peripheral neuropathy (CIPN) demonstrate impaired balance and carry an increased risk of falling. However, prior investigations of postural instability have only compared these individuals against healthy controls, limiting the understanding of impairments associated with CIPN. Therefore, the purpose of this study was to better isolate postural control impairments that are associated with CIPN. Twenty cancer survivors previously diagnosed with breast or colorectal cancer participated. Participants were separated into 3 groups: no prior chemotherapy exposure (CON, n = 6), and recent treatment with taxane- or oxaliplatin-based chemotherapy with no/mild symptoms of CIPN (-CIPN, n = 8) or moderate/severe symptoms of CIPN (+CIPN, n = 6). Postural control was assessed by measuring center of pressure during standing balance conditions that systematically interfered with somatosensory, visual, and/or vestibular information. The presence of CIPN sensory symptoms was associated with impaired postural control, particularly during eyes-closed balance conditions ( P < .05). Additionally, medial-lateral postural instability was more pronounced in the +CIPN group compared with the -CIPN group and CON participants ( P < .05). Greater postural instability during eyes-closed balance in individuals with CIPN is consistent with impaired peripheral sensation. Balance impairments in cancer survivors with CIPN demonstrate the unique challenges in this population and motivate the need for targeted efforts to mitigate postural control deficits that have previously been associated with fall risk.

摘要

患有化疗诱导性周围神经病(CIPN)的个体表现出平衡受损,并增加了跌倒的风险。然而,先前对姿势不稳定的研究仅将这些个体与健康对照组进行了比较,限制了对与 CIPN 相关的损伤的理解。因此,本研究的目的是更好地分离与 CIPN 相关的姿势控制损伤。20 名被诊断患有乳腺癌或结直肠癌的癌症幸存者参与了研究。参与者被分为 3 组:无先前化疗暴露(CON,n=6)、最近接受紫杉醇或奥沙利铂化疗但无/轻度 CIPN 症状(-CIPN,n=8)或中度/重度 CIPN 症状(+CIPN,n=6)。通过测量站立平衡条件下的中心压力来评估姿势控制,这些平衡条件系统地干扰了躯体感觉、视觉和/或前庭信息。CIPN 感觉症状的存在与姿势控制受损有关,尤其是在闭眼平衡条件下(P<0.05)。此外,与 -CIPN 组和 CON 参与者相比,+CIPN 组的内侧-外侧姿势不稳定更为明显(P<0.05)。CIPN 个体在闭眼平衡时的姿势不稳定性更大,与外周感觉受损一致。患有 CIPN 的癌症幸存者的平衡损伤表明该人群存在独特的挑战,并需要有针对性的努力来减轻以前与跌倒风险相关的姿势控制缺陷。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6589/7242799/8f8ee4ceddd4/10.1177_1534735419828823-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6589/7242799/8f8ee4ceddd4/10.1177_1534735419828823-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6589/7242799/8f8ee4ceddd4/10.1177_1534735419828823-fig1.jpg

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