The Effect of Therapeutic Exercises on Balance, Quality of Life, and Pain in Patients Who Were Receiving Neurotoxic Chemotherapy

Abstract

Objective The aim of the study was to evaluate the effect of lower limb strengthening and balance exercises on balance, quality of life and neuropathic pain of the cancer patients receiving neurotoxic chemotherapy. Design Patients who were planning to receive neurotoxic chemotherapy agents were included in the first group. They were trained before the neurotoxic chemotherapy sessions with the 10-wk home-based exercise program including lower limb strengthening and balance exercises. The second group of patients who had received the third cycle of neurotoxic chemotherapy had no exercise program. Both groups were evaluated after the third cycle. Neurocom Balance Master and Berg Balance Scale were used to evaluate balance. The neuropathic pain was questioned by PainDETECT questionnaire and the quality of life was assessed with the European Organization for Research and Treatment of Cancer’s Quality of Life Questionnaire. Results Sixty patients were admitted to this study. Twenty-four patients were in the exercise group (F = 14, M = 10) and 36 patients were in the control group (F = 17, M = 19). Sociodemographic and clinical data of both groups were similar. Berg Balance Scale (P = 0.005), European Organization for Research and Treatment of Cancer’s Quality of Life Questionnaire global quality of life, physical function, and emotional status were higher, and symptom scores and PainDETECT questionnaire score were lower in the exercise group (P < 0.05). Balance tests were different between the groups. Conclusions Strengthening and balance exercises have a valuable effect on balance, quality of life, and neuropathic pain in patients receiving neurotoxic chemotherapy.

A systematic review of behavioural and exercise interventions for the prevention and management of chemotherapy-induced peripheral neuropathy symptoms

“…Control and intervention groups in all RCTs were similar in size but small in numbers (range: 11-19 participants per arm), except for one study with 170 in the intervention group and 185 in the control group [59]. One study adapted a quasi-experimental design whereby two groups received the intervention but at different stages of their chemotherapy treatment [66]. The main author in one study provided additional information about intervention delivery following email contact [57].…”

“…Total Neuropathy Score to measure CIPN symptoms [57] and one study used peripheral deep sensitivity testing only [56]. Five studies utilised validated tools such as the Leeds Assessment of Neuropathic Symptoms and Signs questionnaire [55], CIPN symptoms numeric rating scale [59], QLQ-CIPN20 [60], FACT-GOG NTx [61] and Pain DETECT questionnaire [66]. A combination of PROMs and physician grading score was used in one study [50].…”

“…Frequency per week: daily 55,57,62 , twice a week 50,61,65,66,68,69 , three mes per week 63 , five days per week 56,60,64 Length per session: 10-60 minutes (range); 41 minutes (average)…”

“…Use of mechanical aids and environmental support: therapeu bands 55,60,63,66,68 , pedometer 60 , exercise-tracking website 60 , postural devices 61 , treadmill 64 , sta onary bicycle 63,65 , free weights 64 , in ve sensor screen 63 , balance pads 69 , cherry pit pillows 69 , cross-trainer 69 , cycle ergometer 64,69 , ellip al trainer 64 , exercise mats 64…”

“…Timing of interven n: during treatment 55, 56, 66, 69 during and a treatment [60][61][62] , treatment 50,63,65,68 Intensity of exercise: low 66 , moderate 46,51,52,65 , determined by ra ng or perceived exe on 63 , determined by chemotherapy protocol 64…”