Prince of Wales Clinical School, University of New South Wales, Kensington, Australia.
Prince of Wales Hospital, Randwick, Australia.
Support Care Cancer. 2019 Oct;27(10):3849-3857. doi: 10.1007/s00520-019-04680-w. Epub 2019 Feb 12.
Chemotherapy-induced peripheral neuropathy (CIPN) affects up to 40% of cancer survivors and is associated with functional deficits and an increased falls incidence. There are presently no strongly recommended treatment strategies for CIPN. The aim of this study was to evaluate the impact of a multimodal exercise intervention on CIPN symptoms and related functional deficits, as well as neurophysiologic parameters.
All outcomes were assessed before and after an 8-week exercise intervention (3-weekly sessions) and preceding 8-week control period at baseline, pre-exercise and post-exercise. Outcome measures were objective and patient-reported CIPN, standing and dynamic balance, mobility, quality of life, and sensory and motor nerve excitability and conduction studies.
Twenty-nine cancer survivors (8 male, 21 female; mean age 61.6 ± 11.8 years) with CIPN symptoms affecting function completed all assessments. Objective and patient-reported CIPN, dynamic balance, standing balance in eyes open conditions, mobility and quality of life were improved from pre- to post-exercise (4.0 < F < 10.2; p < .05), with no changes over the control period (p > .21). No changes were observed in sensory or motor neurophysiologic parameters (p > .23).
This study provides encouraging evidence of the rehabilitative potential of multimodal exercise for persisting CIPN in a post-treatment cohort. Large randomised controlled trials are justified to confirm observed benefits and determine the mechanisms and clinical significance.
化疗引起的周围神经病（CIPN）影响多达 40%的癌症幸存者，与功能缺陷和跌倒发生率增加有关。目前尚无强烈推荐的 CIPN 治疗策略。本研究旨在评估多模式运动干预对 CIPN 症状及相关功能缺陷和神经生理参数的影响。
所有结果均在 8 周运动干预（每周 3 次）前后以及基线、运动前和运动后 8 周的对照期进行评估。评估指标包括客观和患者报告的 CIPN、站立和动态平衡、移动能力、生活质量以及感觉和运动神经兴奋性和传导研究。
29 名患有 CIPN 症状影响功能的癌症幸存者（8 名男性，21 名女性；平均年龄 61.6±11.8 岁）完成了所有评估。客观和患者报告的 CIPN、动态平衡、睁眼站立平衡、移动能力和生活质量均在运动后得到改善（4.0<F<10.2；p<.05），而在对照期无变化（p>.21）。感觉或运动神经生理参数无变化（p>.23）。
本研究为多模式运动对治疗后持续性 CIPN 的康复潜力提供了令人鼓舞的证据。需要进行大型随机对照试验来证实观察到的益处，并确定其机制和临床意义。
