Poster Presentation Cancer Survivorship 2019

Exercise as medicine for cancer survivors with chemotherapy-induced peripheral neuropathy (CIPN): A pilot study (#209)

J. Matt McCrary 1 , David Goldstein 1 , Tiffany Li 2 , Hannah Timmins 2 , Ben Barry 3 4 , Carolina Sandler 5 6 7 , Terry Trinh 1 , Eva Battaglini 1 , Susanna Park 2
  1. Prince of Wales Clinical School (UNSW Australia), Randwick, NSW, Australia
  2. Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
  3. School of Medical Sciences , University of New South Wales, Sydney, NSW, Australia
  4. School of Clinical Medicine, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
  5. Cancer Prevention Research Centre, School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
  6. School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
  7. The Kirby Institute, University of New South Wales, Sydney, NSW, Australia

Aims: Chemotherapy-induced peripheral neuropathy (CIPN) is a prominent side effect of cancer treatment affecting up to 40% of cancer survivors and associated with balance and mobility deficits and an increased falls incidence. There are presently no recommended treatment strategies for CIPN, although exercise has demonstrated promise in limited studies. The aim of this study is to investigate the impact of exercise rehabilitation for cancer survivors with persistent CIPN using comprehensive assessments of patient function and CIPN symptoms, including neurophysiologic endpoints.

Methods: Cancer survivors ≥3-months post-treatment with known neurotoxic chemotherapies and reporting CIPN symptoms affecting function completed an 8-week exercise intervention consist of three weekly one-hour sessions including balance, resistance, and cardiovascular exercises conducted at a rating of perceived exertion of 13-15 out of 20. Patients attended for a baseline assessment, followed by an 8-week control period, pre-exercise assessment, 8-week exercise program, and post-exercise assessment. Assessments included evaluation of objectively assessed and patient-reported neuropathy, standing balance (four conditions), dynamic balance, mobility, quality of life, and sensory and motor nerve excitability and conduction studies.

Results: 29 cancer survivors (8 male; 61.6 ± 11.8 years; target sample N=26) completed all assessments. Objectively-assessed and patient-reported CIPN, dynamic balance, mobility, quality of life, and standing balance in eyes open conditions were significantly improved from pre- post-exercise (4.0<F<10.2; p<.05), with no significant baseline to pre-exercise changes (p>.21). No pre- to post-exercise changes were observed in standing balance in eyes closed conditions or any sensory or motor neurophysiologic parameters (p>.10).

Conclusions: This study provides promising evidence using comprehensive assessments of the rehabilitative potential of exercise for cancer survivors with persisting CIPN. Given the implications for quality of life in cancer survivorship, large randomised controlled trials are justified and needed to confirm observed benefits and determine the mechanisms and clinical significance of exercise effects in CIPN.