Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Bakırçay University, Izmir, Turkey.
Department of Medical Oncology, Faculty of Medicine, Izmir Bakırçay University, Izmir, Turkey.
BMC Cancer. 2023 Oct 14;23(1):981. doi: 10.1186/s12885-023-11494-x.
Chemotherapy is a well-known risk factor for sensorial and motor disturbances. Chemotherapy induced peripheral neuropathy (CIPN) which predominantly affects sensory nerves might cause a diminished fine motor function. This prospective observational study aimed to assess the sensorimotor functions of breast cancer patients before, during, and after chemotherapy.
A total of 56 breast cancer patients were evaluated at three different times as follows: T1 (before chemotherapy), T2 (middle chemotherapy), and T3 (completion of chemotherapy). Motor function was assessed with handgrip strength (HGS), peripheral muscle strength (PMS), and the Minnesota Manual Dexterity Test (MMDT). Semmes Weinstein Monofilament Test (SWMT) was performed to assess the sensory function. Fatigue was evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Module Cancer Related Fatigue (EORTC-QLQ-FA12), respectively.
HGS and MMDT were found significant (χ: 11.279, p = 0.004 and χ: 9.893, p = 0.007, respectively) whereas PMS was not found significant (F (2,110) = 1.914, p = 0.152). Pairwise comparisons with Bonferroni adjustments revealed that HGS was found significant between T1 and T3, while significant results were obtained between T1 and T2 as well as T2 and T3 in MMDT (p = 0.01 and p = 0.042). There were significant results in some reference points of SWMT, though they were not found after pairwise comparisons with Bonferroni adjustment (p > 0.05). Fatigue was found significantly increased from T1 through T3 (Median: 19.44 vs 27.77, z: -2.347, p = 0.019, Wilcoxon test).
Our study showed that decreased handgrip strength and fine motor function, as well as increased fatigue, are evident during the chemotherapy. SWMT can be an optional assessment in the context of tracking changes in cutaneous sensation during chemotherapy due to its non-invasive, cheap, and easily repeatable features among cancer patients. To preserve functional capacity as well as independence in daily living, precautions and follow up assessments during the systemic therapy process should be integrated as early as possible to prevent future deteriorations in daily life for patients who undergo chemotherapy.
NCT04799080.
化疗是导致感觉和运动障碍的已知危险因素。化疗引起的周围神经病（CIPN）主要影响感觉神经，可能导致精细运动功能下降。这项前瞻性观察研究旨在评估乳腺癌患者在化疗前后的感觉运动功能。
共有 56 名乳腺癌患者在三个不同时间点进行评估：T1（化疗前）、T2（化疗中）和 T3（化疗完成）。手部握力（HGS）、外周肌肉力量（PMS）和明尼苏达州手动灵巧性测试（MMDT）用于评估运动功能。Semmes Weinstein 单丝试验（SWMT）用于评估感觉功能。欧洲癌症研究与治疗组织生活质量模块癌症相关疲劳（EORTC-QLQ-FA12）分别评估疲劳。
HGS 和 MMDT 有显著差异（χ：11.279，p=0.004 和 χ：9.893，p=0.007），而 PMS 无显著差异（F（2,110）=1.914，p=0.152）。经 Bonferroni 调整的两两比较显示，HGS 在 T1 和 T3 之间有显著差异，而 MMDT 在 T1 和 T2 以及 T2 和 T3 之间也有显著差异（p=0.01 和 p=0.042）。SWMT 的一些参考点也有显著结果，但经 Bonferroni 调整的两两比较后无显著差异（p>0.05）。从 T1 到 T3，疲劳明显增加（中位数：19.44 与 27.77，z：-2.347，p=0.019，Wilcoxon 检验）。
我们的研究表明，在化疗期间，手部握力和精细运动功能下降，以及疲劳增加。由于其在癌症患者中具有非侵入性、廉价和易于重复的特点，SWMT 可以作为评估化疗过程中皮肤感觉变化的一种选择。为了保持功能能力和日常生活的独立性，在接受化疗的患者中，应尽早整合系统治疗过程中的预防措施和随访评估，以防止日常生活质量的进一步恶化。
NCT04799080。
