Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2017

The effects of exercise training on neurophysiology, symptoms, and function in cancer survivors with chemotherapy-induced peripheral neuropathy (#185)

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

Chemotherapy-induced peripheral neuropathy (CIPN) is a prominent side effect of cancer treatment associated with numbness, tingling, increased postural instability and increased falls risk in affected patients. Exercise has been shown to reduce postural sway, a correlate of balance deficits, in a CIPN cohort, but the effect of exercise on neurophysiologic parameters is unknown. Twelve cancer survivors (3 male; 64.3 ± 10.3 years) ≥ 3-months post-treatment and displaying National Cancer Institute grade ≥ 2 CIPN symptoms underwent a pilot 8-week exercise intervention and series of functional and neurophysiologic assessments. Assessments were administered at baseline, following an 8-week control period, and after a subsequent 8-week exercise intervention. Outcome measures were the Total Neuropathy Score (objective neurophysiologic assessment), postural sway, patient reported outcome questionnaires (SF-36, CIPN-20, CIPN-R-ODS), grooved pegboard test (fine motor function), five times sit-to-stand test (leg strength), and six-minute walk test (gait/aerobic fitness). Postural sway was quantified using Swaymeter in four conditions of increasing balance challenge. The intervention consisted of one-hour sessions of balance, resistance, and cardiovascular exercises three times per week, conducted at a rating of perceived exertion of 13-15 out of 20 (moderate-hard intensity exercise). Half of the exercise sessions were conducted under supervision of exercise physiology staff, while the other half were prescribed by staff and conducted without supervision at the patient’s home. Adherence to home and clinical exercise prescriptions was 86%. Outcome measures were not significantly different from baseline to the end of the control period (0.16<|t|<1.52; all p>.17). Significant improvements in Total Neuropathy Score (18% reduction; p<.05), neuropathy symptoms (CIPN-20; 18% reduction, p=.03), quality of life (SF-36; 16% increase, p=.03), and postural sway on an unstable surface (43% reduction, p<.03) were found following the exercise intervention. Multimodal exercise programs may help ameliorate neuropathy symptoms and functional deficits in cancer survivors with CIPN.