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Dai ACK, Mackenzie L. Falls experienced by adult cancer survivors: a scoping review. Disabil Rehabil 2024:1-21. [PMID: 38946208 DOI: 10.1080/09638288.2024.2362399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 05/28/2024] [Indexed: 07/02/2024]
Abstract
PURPOSE Accidental falls among adult cancer survivors are a health concern. Falls impose economic burdens and detrimental consequences to cancer survivors. This review aimed to synthesize findings from published research to explore the relationship between falls and cancer diagnosis and treatment among cancer survivors. MATERIALS AND METHODS A scoping review was conducted using four databases (Medline, EMBASE, CINAHL, and Scopus) for the years 2001-2021. A total of 425 abstracts were identified after removing duplicates. A second search for the years 2022-2023 was completed where 80 abstracts were identified. Abstract screening, full-text review, and data extraction were conducted. Study characteristics and key findings were extracted from full texts. Descriptive numerical summaries were presented, and narrative analyses were performed. RESULTS AND CONCLUSIONS A total of 42 articles were included in the scoping review which demonstrated (1) an increased prevalence of falls among cancer survivors, (2) the presence of cancer-specific fall risk factors, (3) a lack of cancer-specific fall prediction tools, and (4) few fall prevention interventions as part of usual care among cancer survivors. Younger cancer survivors were underrepresented. Cancer survivors should be aware of their risk of falls, and health professionals should ensure that fall prevention is part of usual care.
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Affiliation(s)
- Anson Chuk Kwan Dai
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Rattanakrong N, Siriphorn A, Boonyong S. The alteration of static and dynamic postural stability among women with breast cancer during taxane-based chemotherapy: a descriptive study. Physiother Theory Pract 2024; 40:1172-1180. [PMID: 36305704 DOI: 10.1080/09593985.2022.2139654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 10/08/2022] [Accepted: 10/08/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION Women with breast cancer who underwent taxane-based chemotherapy demonstrate diminished postural stability. However, the data concerning dynamic postural stability among women with breast cancer during taxane-based chemotherapy remains insufficient. PURPOSE To investigate postural stability among women with breast cancer during taxane-based chemotherapy. METHODS Fifteen women with breast cancer participated in this study. Postural stabilities were assessed at five intervals during the course of chemotherapy treatment. Static postural stability was measured during single leg with eyes open (SEO) and eyes closed (SEC) conditions, while dynamic postural stability was measured during performance of the limit of stability test (LOS). Postural stability was described using 95% confidence ellipse area (EA), center of pressure (COP) path length (PL), and COP average velocity (AV). RESULTS For static postural stability assessment, SEO condition was found to have significant increases in EA, PL, and AV (p = .001, p < .001, and p = .02, respectively). For dynamic postural stability assessment, a significant difference in EA was observed in the forward, backward, right, and left directions (p = .02, p = .02, p < .001, and p = .01, respectively). In addition, a significant difference in PL was found while performing in a backward direction (p = .02). CONCLUSIONS The findings showed that women with breast cancer may have experienced decreased static and dynamic postural stability.
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Affiliation(s)
- Nida Rattanakrong
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
- Department of Rehabilitation Medicine, Physical Therapy Unit, Bangkok, Thailand
| | - Akkradate Siriphorn
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Sujitra Boonyong
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
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Carretti G, Dabraio A, Manetti M, Marini M. Biofeedback-Based Proprioceptive Training to Improve Functional Prerequisites of Dragon Boating in Breast Cancer Survivors. Eur J Investig Health Psychol Educ 2024; 14:1351-1368. [PMID: 38785587 PMCID: PMC11120340 DOI: 10.3390/ejihpe14050089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
Breast cancer (BC)-related sequelae drastically impact the psychophysical functioning and quality of life of affected women. Adapted physical activity (APA) has proved to effectively counteract these impairments in a non-medicalized framework. In particular, dragon boats are able to promote body functionality, social interaction, and quality of life in BC survivors, but the literature on specific motor gestures is scarce and practice is still based more on a re-educative perspective than a performative one. In this context, the present longitudinal study investigated the benefits of an adapted biofeedback-based sensorimotor training intervention on upper body functionality in a team of dragon ladies. The 8-week intervention was conceived as integrated dry workout sessions led by an APA kinesiologist and applied a novel sensorized proprioceptive device, such as a Libra board. Post-protocol evaluation revealed a significant improvement in bilateral upper limb mobility, core endurance, and trunk stability along with a distress decrease and quality of life enhancement through validated assessment tools. Our findings suggest that integrating biofeedback-based workout sessions can effectively promote upper body functionality in BC survivors practicing dragon boating. Furthermore, our innovative approach could help spread methodological hints able to boost exercise adherence in this target population, thus counteracting cancer recurrence while promoting overall well-being.
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Affiliation(s)
| | | | | | - Mirca Marini
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, 50134 Florence, Italy; (G.C.); (A.D.); (M.M.)
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Reinmann A, Koessler T, Bodmer A, Baud-Grasset A, Mentha G, Gligorov J, Bruyneel AV. Feasibility, criterion and construct convergent validity of the 2-minute walk test and the 10-meter walk test in an oncological context. Heliyon 2023; 9:e22180. [PMID: 38045222 PMCID: PMC10692807 DOI: 10.1016/j.heliyon.2023.e22180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 12/05/2023] Open
Abstract
Objective To examine the feasibility, the criterion, and the construct convergent validity of the 2-Minute Walk Test (2MWT) and the 10-Meter Walk Test (10MeWT) against the 6-Minute Walk Test (6MWT) to assess walking capacity in people with cancer. The criterion concurrent validity of a self-test version of the 10MeWT (10MeWTself-test) was also evaluated against the 10MeWT. Methods Fifty-six people with cancer performed the 2MWT, the 10MeWT at comfortable and fast speeds, the 6MWT, and the 10MeWTself-test. The feasibility of the tests was assessed using safety, adverse events, space requirements, time taken to administer and interpret the tool, equipment or training required, cost, and portability as criteria. Validity was assessed using Pearson correlation coefficients and Bland Altman plots. Results The 2MWT, 6MWT, 10MeWT, and 10MeWTself-test were feasible for people with cancer. The 2MWT and the 10MeWT results were moderately to strongly correlated with the 6MWT results (0.61 < r < 0.84, p < 0.001). The 10MeWTself-test results were strongly correlated with the 10MeWT results at comfortable and fast speeds (r = 0.99, p < 0.001). Conclusions The 2MWT, 10MeWT, and 10MeWTself-test are simple, rapid, and feasible tests for use in people with cancer. The strong correlation between the 2MWT and 6MWT results indicates that the 2MWT can be used as an alternative walking capacity assessment tool. The 10MeWT results moderately correlated with those of the other two tests, suggesting that it partially measures the same construct of walking capacity in walking-independent outpatients with cancer. The 10MeWTself-test showed promising results but needs further investigations in ecological settings.
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Affiliation(s)
- Aline Reinmann
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
- Sorbonne University, INSERM U938, Centre de Recherche Saint Antoine, CRSA, Paris, France
| | - Thibaud Koessler
- Service of Oncology, Geneva University Hospitals, Geneva, Switzerland
- University of Geneva, Geneva, Switzerland
| | - Alexandre Bodmer
- Service of Oncology, Geneva University Hospitals, Geneva, Switzerland
- University of Geneva, Geneva, Switzerland
| | - Axelle Baud-Grasset
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Géraldine Mentha
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Joseph Gligorov
- Sorbonne University, INSERM U938, Centre de Recherche Saint Antoine, CRSA, Paris, France
- University Institute of Cancerology AP-HP Sorbonne University, Medical Oncology site Tenon, Paris, France
| | - Anne-Violette Bruyneel
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
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Teng C, Chiarovano E, Tighe D, Bui KT, Venkatesha, Blinman PL, MacDougall HG, Vardy JL. Exploring assessment of balance using virtual reality in patients at risk of chemotherapy-induced peripheral neuropathy. Intern Med J 2023; 53:1356-1365. [PMID: 35762188 PMCID: PMC10946840 DOI: 10.1111/imj.15861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/16/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-limiting toxicity for people treated for cancer. Impaired balance and falls are functional consequences of CIPN. Virtual reality (VR) technology may be able to assess balance and identify patients at risk of falls. AIMS To assess the impact of potentially neurotoxic chemotherapy on balance using VR, and explore associations between VR balance assessment, falls and CIPN. METHODS This prospective, repeated measures longitudinal study was conducted at two Australian cancer centres. Eligible participants were commencing adjuvant chemotherapy containing a taxane for breast cancer, or oxaliplatin for colorectal cancer (CRC), per institutional guidelines. Balance assessments using VR were conducted at baseline, end of chemotherapy and 3 and 6 months after completion of chemotherapy. Participants also completed a comprehensive CIPN assessment comprising clinical and patient-reported outcomes, and recorded falls or near falls. RESULTS Out of 34 participants consented, 24 (71%) had breast cancer and 10 (29%) had CRC. Compared to baseline, balance threshold was reduced in 10/28 (36%) evaluable participants assessed at the end of chemotherapy, and persistent in 7/22 (32%) at 6 months. CIPN was identified in 86% at end of chemotherapy and persisted to 6 months after chemotherapy completion in 73%. Falls or near falls were reported by 12/34 (35%) participants, and were associated with impaired VR balance threshold (P = 0.002). CONCLUSIONS While VR balance assessment was no better at identifying CIPN than existing measures, it is a potential surrogate method to assess patients at risk of falls from CIPN.
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Affiliation(s)
- Christina Teng
- Concord Cancer CentreConcord Repatriation General HospitalSydneyNew South WalesAustralia
- Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
- Department of Medical OncologyCentral Coast Cancer CentreSydneyNew South WalesAustralia
| | - Elodie Chiarovano
- School of PsychologyUniversity of SydneySydneyNew South WalesAustralia
| | - David Tighe
- Faculty of MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Kim Tam Bui
- Concord Cancer CentreConcord Repatriation General HospitalSydneyNew South WalesAustralia
- Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
| | - Venkatesha
- Clinical Research CentreSydney Local Health DistrictSydneyNew South WalesAustralia
| | - Prunella L. Blinman
- Concord Cancer CentreConcord Repatriation General HospitalSydneyNew South WalesAustralia
- Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
| | | | - Janette L. Vardy
- Concord Cancer CentreConcord Repatriation General HospitalSydneyNew South WalesAustralia
- Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
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Reddy RS, Alkhamis BA, Kirmani JA, Uddin S, Ahamed WM, Ahmad F, Ahmad I, Raizah A. Age-Related Decline in Cervical Proprioception and Its Correlation with Functional Mobility and Limits of Stability Assessed Using Computerized Posturography: A Cross-Sectional Study Comparing Older (65+ Years) and Younger Adults. Healthcare (Basel) 2023; 11:1924. [PMID: 37444758 DOI: 10.3390/healthcare11131924] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/09/2023] [Accepted: 07/01/2023] [Indexed: 07/15/2023] Open
Abstract
Cervical proprioception and its implications on postural stability are crucial in older adults. Understanding their relationship is important in understanding and preventing falls in older adults. This research aims to evaluate the proprioceptive, functional mobility, and limits of stability (LOS) variables among two age groups: individuals aged 65 and above and those below 65. A secondary goal of the study is to analyze the relationship between cervical proprioception, functional mobility, and the LOS. METHODS In this cross-sectional study, 100 participants each were included in the older and younger groups. Researchers employed the target reposition technique to assess cervical proprioception and measured the joint position error (JPE) in degrees. Functional mobility was estimated using the Berg balance scale (BBS) and timed up-and-go test (TUG). In addition, dynamic posturography was utilized to evaluate variables related to the LOS, including reaction time, maximum excursion, and directional control. RESULTS The magnitudes of the mean cervical JPE are larger (p < 0.001), and functional mobility (p < 0.001) and the LOS (p < 0.001) are impaired in older individuals compared to the younger ones. The cervical proprioception is significantly associated with functional mobility (p < 0.001), and the LOS (p < 0.001). CONCLUSION In older adults aged above 65 years, cervical proprioception, functional mobility, and the LOS are impaired. Older adults with greater cervical JPE had more impaired functional mobility and LOS parameters. When evaluating or treating older adults with problems with their balance or falls, these factors should be considered.
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Affiliation(s)
- Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid Universiry, Abha 61421, Saudi Arabia
| | - Batool Abdulelah Alkhamis
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid Universiry, Abha 61421, Saudi Arabia
| | - Junaid Ahmed Kirmani
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Shadab Uddin
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Waseem Mumtaz Ahamed
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Fuzail Ahmad
- Respiratory Care Department, College of Applied Sciences, Almaarefa University, Riyadh 13713, Saudi Arabia
| | - Irshad Ahmad
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid Universiry, Abha 61421, Saudi Arabia
| | - Abdullah Raizah
- Department of Orthopaedics, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
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Haynam ML, Chaplow ZL, DeScenza VR, Bowman JD, Dispennette K, Zhang X, Kilar M, Hohn S, Fairman CM, Lustberg MB, Focht BC. Design and methods of a translational, community-based, lifestyle weight management pilot intervention trial in breast cancer survivors with overweight or obesity. Contemp Clin Trials Commun 2023; 33:101154. [PMID: 37250507 PMCID: PMC10220259 DOI: 10.1016/j.conctc.2023.101154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 05/03/2023] [Accepted: 05/14/2023] [Indexed: 05/31/2023] Open
Abstract
Background Breast cancer survivors (BCS) with overweight or obesity are at heightened risk of cancer recurrence, cardiometabolic disease, and compromised quality of life. Given the prevalence of significant weight gain during and following breast cancer treatment, there is growing recognition of the need to develop efficacious, widely-accessible, weight management programs for BCS. Unfortunately, access to evidence-based weight management resources for BCS remains limited and little is known of the optimal theoretical basis, program components, and mode of delivery for community-based interventions. The primary aim of the Healthy New Albany Breast Cancer (HNABC) pilot trial was to determine the safety, feasibility, and preliminary efficacy of delivering a translational, evidence-based, and theory-driven lifestyle weight management intervention to BCS with overweight or obesity in the community setting. Methods HNABC was a single-arm, pilot trial evaluating a 24-week, multi-component intervention leveraging exercise, dietary modification, and group-mediated cognitive behavioral (GMCB) counseling components designed to facilitate lifestyle behavior change and promote sustained independent adherence. Assessments of various objectively-determined and patient-reported outcomes and theory-derived determinants of behavioral adoption and maintenance were obtained at baseline, 3- and 6-month follow-up. Measures of trial feasibility were calculated prospectively throughout the study. Conclusion Findings from the HNABC pilot trial will provide evidence demonstrating the feasibility and preliminary efficacy of a multi-component, community-based, GMCB lifestyle weight management intervention for BCS. Results will inform the design of a future, large-scale, randomized controlled efficacy trial. If successful, this approach could offer a widely accessible, community-based intervention model for weight management programs in BCS.
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Affiliation(s)
| | | | | | | | | | | | - Megan Kilar
- The Ohio State University, Columbus, OH, USA
| | | | | | | | - Brian C. Focht
- The Ohio State University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
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Suzuki K, Morishita S, Nakano J, Okayama T, Inoue J, Tanaka T, Fukushima T. Neurological Outcomes of Chemotherapy-Induced Peripheral Neuropathy in Patients With Cancer: A Systematic Review and Meta-Analysis. Integr Cancer Ther 2023; 22:15347354231185110. [PMID: 37822238 PMCID: PMC10571681 DOI: 10.1177/15347354231185110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/02/2023] [Accepted: 06/13/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND This systematic review and meta-analysis aimed to determine whether chemotherapy-induced peripheral neuropathy (CIPN) affects the risk of falls and physical function in patients with cancer. METHODS A literature search was conducted in the CINAHL, Scopus, and PubMed databases for articles published from January 1950 to April 2022. Seven review authors retrieved studies using predetermined eligibility criteria, extracted the data, and evaluated the quality. RESULTS Nine studies were included in the analysis. Patients with CIPN had a significantly higher risk of falls than those without CIPN (risk ratio = 1.38, 95% confidence interval [CI] =1.18-1.62). Patients with CIPN had lower grip strength (standardized mean difference [SMD] =-0.42, 95% CIs = -0.70 to -0.14, P = .003), longer chair stand time (SMD = 0.56, 95% CIs = -0.01 to 1.17, P = .05), worse timed up and go test time (SMD = 0.79, 95% CIs = 0.41 to 1.17, P < .0001), and lower mean Fullerton Advanced Balance scale score (SMD = -0.81, 95% CIs = -1.27 to -0.36, P = .005) than patients without CIPN. There were no significant differences in gait speed (P = .38) or Activities-specific Balance Confidence Scale score (P = .09) between patients with and without CIPN. CONCLUSIONS This systematic review and meta-analysis demonstrated that patients with CIPN are prone to falls and impaired balance function and muscle strength.
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Affiliation(s)
| | | | | | | | - Junichiro Inoue
- Kobe University Hospital International Clinical Cancer Research Center, Kobe, Japan
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Reinmann A, Bruyneel AV, Gligorov J, Mesure S, Combescure C, Koessler T, Bodmer A. Influence of chemotherapy on postural control and quality of life in women with gynaecological cancer: a protocol of a prospective observational study. BMJ Open 2022; 12:e061664. [PMID: 36691184 PMCID: PMC9454005 DOI: 10.1136/bmjopen-2022-061664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 07/31/2022] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Chemotherapy-induced peripheral neuropathy is a frequent side effect of some chemotherapies that can cause postural control disorders and has a serious impact on quality of life (QoL). An enhanced understanding of postural control dysfunction could help build a systematic and accurate assessment as well as specific exercises to limit the impact on QoL. This study aims to assess the influence of chemotherapy on postural control and the QoL for women with gynaecological cancer. METHODS AND ANALYSIS This prospective observational study will include 37 participants with cancer treated using neurotoxic chemotherapy. Their postural control in various conditions (rigid and foam surfaces, eyes open and closed, with and without tendon vibration, and dual tasks), limits of stability, QoL and modified Total Neuropathy Score will be assessed. A linear mixed model will compare postural control pre-chemotherapy and post-chemotherapy. ETHICS AND DISSEMINATION This study was approved by an ethical review board in Geneva (CCER-2020-01639). The study findings will be disseminated through conference presentations and publications in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT04692168.
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Affiliation(s)
- Aline Reinmann
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Anne-Violette Bruyneel
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Joseph Gligorov
- Department of Oncology, AP-HP. Sorbonne University, Paris, France
| | - Serge Mesure
- Institute of Movement Sciences, National Centre of Scientific Research, Aix-Marseille-University, Marseille, France
| | - Christophe Combescure
- CRC & Division of clinical epidemiology, Department of health and community medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Thibaud Koessler
- Service of Oncology, Geneva University Hospitals, Geneva, Switzerland
- University of Geneva, Geneva, Switzerland
| | - Alexandre Bodmer
- Service of Oncology, Geneva University Hospitals, Geneva, Switzerland
- University of Geneva, Geneva, Switzerland
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Rattanakrong N, Siriphorn A, Boonyong S. Incidence and risk factors associated with falls among women with breast cancer during taxane-based chemotherapy. Support Care Cancer 2022; 30:7499-7508. [PMID: 35665857 DOI: 10.1007/s00520-022-07181-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/25/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aims to evaluate the falling incidence density and examine the potential risk factors associated with falling among women with breast cancer during taxane-based chemotherapy. METHODS One hundred and twenty-three women with breast cancer participated in this study. The fall incidence density, taxane-induced peripheral neuropathy (TIPN) symptoms, and physical performance tests were evaluated at five time points throughout chemotherapy treatment. A fall diary was used to record fall incidence during treatment. The fall incidence density was calculated by dividing the number of first fall occurrences by person-time at risk. The risk factors associated with time to first fall were analyzed using the Cox proportional hazards model. The Kaplan-Meier curve illustrated the probability of survival from a fall during chemotherapy treatment. RESULTS Over the course of treatment, 29 (23.58%) participants reported falls. The fall incidence density was 3 per 1000 person-day. This study discovered a significant link between age (adjusted HR (HRadj) = 1.07; 95% CI: 1.02-1.13) and BMI (HRadj = 1.11; 95% CI: 1.02-1.21) and falling. CONCLUSIONS Women with breast cancer could fall for the first time at any time after starting chemotherapy until the end of the follow-up period. Furthermore, time to first fall was associated with age and BMI. Early detection of falling in women with breast cancer, particularly among older persons and those with a high BMI, may be essential to preventing falls.
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Affiliation(s)
- Nida Rattanakrong
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, 154 Rama I Road, Wangmai, Pathumwan, Bangkok, Thailand.,Department of Rehabilitation Medicine, Physical Therapy Unit, Chulabhorn Hospital, Bangkok, Thailand
| | - Akkradate Siriphorn
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, 154 Rama I Road, Wangmai, Pathumwan, Bangkok, Thailand
| | - Sujitra Boonyong
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, 154 Rama I Road, Wangmai, Pathumwan, Bangkok, Thailand.
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Wang AB, Housley SN, Flores AM, Cope TC, Perreault EJ. Cancer survivors post-chemotherapy exhibit unique proprioceptive deficits in proximal limbs. J Neuroeng Rehabil 2022; 19:32. [PMID: 35321749 PMCID: PMC8944065 DOI: 10.1186/s12984-022-01010-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oxaliplatin (OX) chemotherapy for colorectal cancer is associated with adverse neurotoxic effects that can contribute to long-term sensorimotor impairments in cancer survivors. It is often thought that the sensorimotor impairments are dominated by OX-induced dying-back sensory neuropathy that primarily affects the distal regions of the limb. Recent preclinical studies have identified encoding dysfunction of muscle proprioceptors as an alternative mechanism. Unlike the dying-back sensory neuropathy affecting distal limbs, dysfunction of muscle proprioceptors could have more widespread effects. Most investigations of chemotherapy-induced sensorimotor impairments have considered only the effects of distal changes in sensory processing; none have evaluated proximal changes or their influence on function. Our study fills this gap by evaluating the functional use of proprioception in the shoulder and elbow joints of cancer survivors post OX chemotherapy. We implemented three multidirectional sensorimotor tasks: force matching, target reaching, and postural stability tasks to evaluate various aspects of proprioception and their use. Force and kinematic data of the sensorimotor tasks were collected in 13 cancer survivors treated with OX and 13 age-matched healthy controls. RESULTS Cancer survivors exhibited less accuracy and precision than an age-matched control group when they had to rely only on proprioceptive information to match force, even for forces that required only torques about the shoulder. There were also small differences in the ability to maintain arm posture but no significant differences in reaching. The force deficits in cancer survivors were significantly correlated with self-reported motor dysfunction. CONCLUSIONS These results suggest that cancer survivors post OX chemotherapy exhibit proximal proprioceptive deficits, and that the deficits in producing accurate and precise forces are larger than those for producing unloaded movements. Current clinical assessments of chemotherapy-related sensorimotor dysfunction are largely limited to distal symptoms. Our study suggests that we also need to consider changes in proximal function. Force matching tasks similar to those used here could provide a clinically meaningful approach to quantifying OX-related movement dysfunction during and after chemotherapy.
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Affiliation(s)
- Allison B Wang
- Department of Biomedical Engineering, Northwestern University, 355 E Erie St 21st Floor, Evanston, IL, 60611, USA.
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA.
- Shirley Ryan AbilityLab, Chicago, IL, USA.
| | - Stephen N Housley
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Ann Marie Flores
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Cancer Survivorship Institute, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Timothy C Cope
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
- W.H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Georgia Institute of Technology, Atlanta, GA, USA
- Integrated Cancer Research Center, Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
| | - Eric J Perreault
- Department of Biomedical Engineering, Northwestern University, 355 E Erie St 21st Floor, Evanston, IL, 60611, USA
- Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine and Rehabilitation, Northwestern, Chicago, IL, USA
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Waibel S, Wehrle A, Müller J, Bertz H, Maurer C. Type of exercise may influence postural adaptations in chemotherapy-induced peripheral neuropathy. Ann Clin Transl Neurol 2021; 8:1680-1694. [PMID: 34278743 PMCID: PMC8351395 DOI: 10.1002/acn3.51426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 06/15/2021] [Accepted: 06/15/2021] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Traditional posturography measurements characterize postural instability in patients with chemotherapy-induced peripheral neuropathy (CIPN), while underlying postural control mechanisms remain unclear. Taking a model-based approach can yield insights into these mechanisms. This study's aim was to characterize the modifications in postural control of CIPN patients associated with exercise in relation to the postural behavior of healthy control participants (hCON) via an exploratory approach. METHODS Thirty-one CIPN patients were randomly assigned to two interventions (balance plus moderate endurance training vs. moderate endurance training only) and exercised twice per week over 12 weeks. Baseline data were compared to 36 matched hCONs. We recorded spontaneous sway and postural reactions to platform tilts using Optotrak and a Kistler force platform pre- and post-intervention. Data interpretation relied on a model-based parameter identification procedure. RESULTS Spontaneous sway amplitudes were larger and postural reactions smaller, with a relative phase advance, in our pre-intervention patients than the hCONs. Post-intervention, spontaneous sway, and postural reactions were reduced and the sensory-motor ratio larger in both groups, while the postural reaction timing differed between groups. INTERPRETATION The abnormally small postural reactions in CIPN patients before the intervention can be interpreted as the consequence of abnormally strong velocity control-a strategy modification that may serve as a prediction mechanism to compensate for the lack of timely and accurate proprioceptive signals. While both groups reduced postural sway and showed an adapted sensory-motor ratio post-intervention, the interventions seemed to trigger different velocity control strategies. This study emphasizes the need for taking a more differentiated perspective on intervention effects. TRIAL REGISTRATION German Clinical Trials Register (DRKS) number: DRKS00005419, prospectively registered on November 19, 2013.
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Affiliation(s)
- Sarah Waibel
- Department of Neurology and Neuroscience, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anja Wehrle
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany.,Institute for Exercise and Occupational Medicine, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Jana Müller
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Working Group Exercise Oncology, Department of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Heidelberg, Germany
| | - Hartmut Bertz
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Maurer
- Department of Neurology and Neuroscience, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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13
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Medina HN, Liu Q, Cao C, Yang L. Balance and vestibular function and survival in US cancer survivors. Cancer 2021; 127:4022-4029. [PMID: 34265083 DOI: 10.1002/cncr.33787] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 06/18/2021] [Accepted: 06/18/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cancer and its treatment damage the musculoskeletal system and induce neurotoxicity, affecting the key sensory inputs for maintaining balance. The present study describes the pattern of balance impairment and evaluated its association with mortality among US cancer survivors. METHODS Data on a nationally representative sample of cancer survivors from the US National Health and Nutrition Examination Survey from 1999 to 2015 was analyzed. Sensory-specific balance impairment was measured at baseline by the modified Romberg test of standing balance on firm and compliant support surfaces. The linked mortality data were updated through December 31, 2015. RESULTS Among 511 cancer survivors, 282 (48.3%) had a balance impairment, predominantly attributing to vestibular dysfunction (251; 89.0% of 282 and 44.5% of 511). A higher prevalence of balance impairment was observed among cancer survivors with advanced age, lower socioeconomic status or educational attainment, body mass index <25 kg/m2 , and an inactive lifestyle. During up to 16.4 years of follow-up (median, 11.3 years; 5088 person-years), 253 cancer survivors had died. Cancer survivors with a balance impairment had a 63% higher risk of death from all causes (hazard ratio, 1.63; 95% confidence interval [CI], 1.12-2.38) after adjusting for sociodemographic factors, comorbidities, and cancer type. Specifically, those with vestibular dysfunctions had approximately 1.54 (95% CI, 1.05-2.27) times the risk of death compared to those without any balance impairment. These associations were stronger in males than in females. CONCLUSIONS In a US nationally representative sample of cancer survivors, balance impairment and vestibular dysfunctions were prevalent and associated with heightened all-cause mortality.
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Affiliation(s)
- Heidy N Medina
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida
| | - Qinran Liu
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida
| | - Chao Cao
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada.,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Wrisley DM, McLean G, Hill JB, Oddsson LIE. Long-Term Use of a Sensory Prosthesis Improves Function in a Patient With Peripheral Neuropathy: A Case Report. Front Neurol 2021; 12:655963. [PMID: 34248817 PMCID: PMC8260940 DOI: 10.3389/fneur.2021.655963] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/27/2021] [Indexed: 12/25/2022] Open
Abstract
Background: Peripheral neuropathy (PN) can result in either partial or complete loss of distal sensation resulting in an increased fall risk. Walkasins® uses a shoe insert to detect the magnitude and direction of sway and sends signals to a leg unit that provides sensory balance cues. The objective of this case report is to describe the long-term influence of the Walkasins® lower limb sensory neuroprosthesis on balance and gait for an individual with diabetic PN. Case Description: A 51-year-old male with a 3-year history of PN and a 10-year history of type II diabetes mellitus was fitted bilaterally with Walkasins® and utilized them 8-10 hours/day for more than 2 years. Although, vibration and tactile sensation thresholds were severely impaired at his 1st metatarsophalangeal joint and the lateral malleolus bilaterally he could perceive tactile stimuli from the Walkasins® above the ankles. Outcomes: Following Walkasins® use, his Activities-specific Balance Confidence Scale (ABC) scores improved from 33 to 80%. His mean Vestibular Activities of Daily Living (VADL) scores decreased from 3.54 to 1. His Functional Gait Assessment (FGA) scores increased from 13/30 to 28/30 and his miniBESTest scores improved from 15/28 to 26/28. Gait speed increased from 0.23 to 1.5 m/s. The patient described a decrease in pain and cramping throughout his lower extremities and an increase in function. Discussion: Gait and balance improved with the use of the Walkasins® and participation in a wellness program. This improvement suggests that the use of sensory substitution devices, such as the Walkasins®, may replace sensory deficits related to gait and balance dysfunction experienced by patients with PN. Further research is needed to determine if other patients will have a similar response and what the necessary threshold of sensory function is to benefit from use of the Walkasins®.
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Affiliation(s)
- Diane M. Wrisley
- Department of Physical Therapy, Wingate University, Wingate, NC, United States
- Doctor of Physical Therapy Program, College of St Mary, Omaha, NE, United States
| | - Gillian McLean
- Department of Physical Therapy, Wingate University, Wingate, NC, United States
- Fyzical Therapy and Balance Centers, Las Vegas, NV, United States
| | - Jennifer Baity Hill
- Department of Physical Therapy, Wingate University, Wingate, NC, United States
- OrthoCarolina Outpatient Winston-Salem, Winston-Salem, NC, United States
| | - Lars I. E. Oddsson
- Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, United States
- Recanati School of Community Health, Ben Gurion University of the Negev, Beersheba, Israel
- RxFunction Inc., Eden Prairie, MN, United States
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15
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Murphy SP, Hayward R, Smith JD. Exercise training improves postural steadiness in cancer survivors undergoing chemotherapy. Gait Posture 2021; 87:136-142. [PMID: 33915436 DOI: 10.1016/j.gaitpost.2021.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/02/2021] [Accepted: 04/09/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Cancer and cancer treatments negatively affect somatosensory, vestibular, and visual inputs that regulate postural stability and balance, increasing the risk of falling. Exercise training has been shown to mitigate other negative side effects of cancer treatments, such as reducing peripheral neuropathy. RESEARCH QUESTION How does 12 weeks of supervised exercise training influence postural stability in cancer survivors who receive chemotherapy? METHODS Postural stability of cancer survivors (n = 25; mass = 79.0 ± 22.6 kg; height = 1.66 ± 0.08 m; age = 61 ± 10 years) receiving chemotherapy was assessed prior to and following a 12-week individualized exercise training program by quantifying changes in center of pressure data. A series of 2-factor (pre/post x condition) analysis of variance with repeated measures were used to identify differences between conditions and pre- and post- training program on time and frequency domain measures. RESULTS Mediolateral root mean square excursion (p = 0.040; es = 0.20) and resultant mean frequency (p = 0.044; es = 0.29) of the center of pressure trajectory were found to be significantly different between pre- and post-training program. Further, participants dealt better with perturbations after completing the training program by reducing mediolateral root mean square excursion and 95 % confidence ellipse when visual stimulus was removed. SIGNIFICANCE Supervised exercise training in cancer patients undergoing chemotherapy improves postural stability in the mediolateral direction. Given that mediolateral movement of the center of pressure has previously been associated with fallers in other populations, exercise training during cancer treatments may be beneficial.
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Affiliation(s)
- Shane P Murphy
- School of Sport and Exercise Science, University of Northern Colorado, Campus Box 39, Greeley, CO, 80639, USA; School of Integrative Physiology & Athletic Training, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA.
| | - Reid Hayward
- School of Sport and Exercise Science, University of Northern Colorado, Campus Box 39, Greeley, CO, 80639, USA; University of Northern Colorado Cancer Rehabilitation Institute, Campus Box 6, Greeley, CO, 80639, USA.
| | - Jeremy D Smith
- School of Sport and Exercise Science, University of Northern Colorado, Campus Box 39, Greeley, CO, 80639, USA.
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Müller J, Kreutz C, Ringhof S, Koeppel M, Kleindienst N, Sam G, Schneeweiss A, Wiskemann J, Weiler M. Chemotherapy-induced peripheral neuropathy: longitudinal analysis of predictors for postural control. Sci Rep 2021; 11:2398. [PMID: 33504885 PMCID: PMC7840973 DOI: 10.1038/s41598-021-81902-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 01/12/2021] [Indexed: 11/09/2022] Open
Abstract
Impaired postural control is often observed in response to neurotoxic chemotherapy. However, potential explanatory factors other than chemotherapy-induced peripheral neuropathy (CIPN) have not been adequately considered to date due to primarily cross-sectional study designs. Our objective was to comprehensively analyze postural control during and after neurotoxic chemotherapy, and to identify potential CIPN-independent predictors for its impairment. Postural control and CIPN symptoms (EORTC QLQ-CIPN20) were longitudinally assessed before, during and three weeks after neurotoxic chemotherapy, and in three and six months follow-up examinations (N = 54). The influence of peripheral nerve function as determined by nerve conduction studies (NCS: compound motor action potentials (CMAP) and sensory action potentials (SNAP)), physical activity, and muscle strength on the change in postural control during and after chemotherapy was analyzed by multiple linear regression adjusted for age and body mass index. Postural control, CIPN signs/symptoms, and CMAP/SNAP amplitudes significantly deteriorated during chemotherapy (p < .01). During follow-up, patients recovered from postural instabilities (p < .01), whereas CIPN signs/symptoms and pathologic NCS findings persisted compared to baseline (p < .001). The regression model showed that low CMAP and high SNAP amplitudes at baseline predicted impairment of postural control during but not after chemotherapy. Hence, pre-therapeutically disturbed somatosensory inputs may induce adaptive processes that have compensatory effects and allow recovery of postural control while CIPN signs/symptoms and pathologic peripheral nerve function persist. Baseline NCS findings in cancer patients who receive neurotoxic chemotherapy thus might assist in delineating individual CIPN risk profiles more precisely to which specific exercise intervention programs could be tailor-made.
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Affiliation(s)
- Jana Müller
- Institute of Sports and Sport Science, Heidelberg University, Im Neuenheimer Feld 700, 69120, Heidelberg, Germany.,German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.,Working Group Exercise Oncology, Division of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - Charlotte Kreutz
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ), National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 460, 69120, Heidelberg, Germany.,Faculty of Medicine, Heidelberg University, Im Neuenheimer Feld 672, 69120, Heidelberg, Germany
| | - Steffen Ringhof
- Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstr. 175, 79117, Freiburg, Germany
| | - Maximilian Koeppel
- Working Group Exercise Oncology, Division of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - Nikolaus Kleindienst
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health; Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Georges Sam
- Department of Neurology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Andreas Schneeweiss
- National Center for Tumor Diseases (NCT), Heidelberg University Hospital, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - Joachim Wiskemann
- Working Group Exercise Oncology, Division of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - Markus Weiler
- Department of Neurology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
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Wang AB, Housley SN, Flores AM, Kircher SM, Perreault EJ, Cope TC. A review of movement disorders in chemotherapy-induced neurotoxicity. J Neuroeng Rehabil 2021; 18:16. [PMID: 33494755 PMCID: PMC7836454 DOI: 10.1186/s12984-021-00818-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/12/2021] [Indexed: 02/06/2023] Open
Abstract
Chemotherapy agents used in the standard treatments for many types of cancer are neurotoxic and can lead to lasting sensory and motor symptoms that compromise day-to-day movement functions in cancer survivors. To date, the details of movement disorders associated with chemotherapy are known largely through self-reported symptoms and functional limitations. There are few quantitative studies of specific movement deficits, limiting our understanding of dysfunction, as well as effective assessments and interventions. The aim of this narrative review is to consolidate the current understanding of sensorimotor disabilities based on quantitative measures in cancer survivors who received chemotherapy. We performed literature searches on PubMed and found 32 relevant movement studies. We categorized these studies into three themes based on the movement deficits investigated: (1) balance and postural control; (2) gait function; (3) upper limb function. This literature suggests that cancer survivors have increased postural sway, more conservative gait patterns, and suboptimal hand function compared to healthy individuals. More studies are needed that use objective measures of sensorimotor function to better characterize movement disabilities and investigate the underlying causes, as required for developing targeted assessments and interventions. By updating our understanding of movement impairments in this population, we identify significant gaps in knowledge that will help guide the direction of future research.
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Affiliation(s)
- Allison B Wang
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA. .,Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA. .,Shirley Ryan AbilityLab, 355 E Erie St 21st Floor, Chicago, IL, 60611, USA.
| | - Stephen N Housley
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Ann Marie Flores
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA.,Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA.,Cancer Survivorship Institute, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Sheetal M Kircher
- Cancer Survivorship Institute, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA.,Department of Hematology and Oncology, Northwestern University, Chicago, IL, USA
| | - Eric J Perreault
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA.,Shirley Ryan AbilityLab, 355 E Erie St 21st Floor, Chicago, IL, 60611, USA.,Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA
| | - Timothy C Cope
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA.,W.H. Coulter, Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Georgia Institute of Technology, Atlanta, GA, USA.,Integrated Cancer Research Center, Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
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18
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Factors influencing physical activity in patients with colorectal cancer. Ir J Med Sci 2020; 190:539-546. [PMID: 32772301 DOI: 10.1007/s11845-020-02338-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/04/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Physical activity (PA) is a modifiable health behaviour in patients with colorectal cancer (CRC). Knowing the possible predictors of PA will contribute to producing physical and psychological benefits for CRC patients. OBJECTIVE To investigate the factors that influence PA in patients with CRC. METHODS This cross-sectional study was conducted with 47 participants with CRC. Demographic and clinical characteristics, neuropathic pain (Douleur Neuropathique 4 (DN4)), peripheral muscle strength (knee extensor and flexor, hip extensor and flexor, and ankle dorsiflexor muscle strength), balance (Balance Master System (BMS) and Berg Balance Scale (BBS)), fatigue (Brief Fatigue Inventory (BFI)), PA (International PA Questionnaire Short Form (IPAQ-SF)), and quality of life (36-item Short Form Health Survey (SF-36)) were evaluated. Multiple linear regression analysis was used to determine the variables that have the greatest influence on PA. RESULTS IPAQ-SF score had moderate correlations with knee extensor muscle strength (r = 0.310, p = 0.034), BBS (r = 0.361, p = 0.013), and limit of stability test (movement velocity) score (r = 0.385, p = 0.008), BFI- severity of fatigue (r = - 0.488, p = 0.001), impact of fatigue on daily functioning (r = - 0.421, p = 0.003), and the SF-36 sub-parameters (role limitations due to physical health problems, physical functioning, general health perceptions and vitality) (p < 0.05). Role limitations due to physical problems, knee extensor muscle strength, and severity of fatigue had the greatest influence on PA in patients with CRC with explaining 43% of the variance in PA. CONCLUSIONS This study suggests that quality of life, knee extensor muscle strength, and fatigue have the greatest influence on PA in patients with CRC.
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Loprinzi CL, Lacchetti C, Bleeker J, Cavaletti G, Chauhan C, Hertz DL, Kelley MR, Lavino A, Lustberg MB, Paice JA, Schneider BP, Lavoie Smith EM, Smith ML, Smith TJ, Wagner-Johnston N, Hershman DL. Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers: ASCO Guideline Update. J Clin Oncol 2020; 38:3325-3348. [PMID: 32663120 DOI: 10.1200/jco.20.01399] [Citation(s) in RCA: 418] [Impact Index Per Article: 104.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To update the ASCO guideline on the recommended prevention and treatment approaches in the management of chemotherapy-induced peripheral neuropathy (CIPN) in adult cancer survivors. METHODS An Expert Panel conducted targeted systematic literature reviews to identify new studies. RESULTS The search strategy identified 257 new references, which led to a full-text review of 87 manuscripts. A total of 3 systematic reviews, 2 with meta-analyses, and 28 primary trials for prevention of CIPN in addition to 14 primary trials related to treatment of established CIPN, are included in this update. RECOMMENDATIONS The identified data reconfirmed that no agents are recommended for the prevention of CIPN. The use of acetyl-l-carnitine for the prevention of CIPN in patients with cancer should be discouraged. Furthermore, clinicians should assess the appropriateness of dose delaying, dose reduction, substitutions, or stopping chemotherapy in patients who develop intolerable neuropathy and/or functional impairment. Duloxetine is the only agent that has appropriate evidence to support its use for patients with established painful CIPN. Nonetheless, the amount of benefit from duloxetine is limited.Additional information is available at www.asco.org/survivorship-guidelines.
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Affiliation(s)
| | | | | | | | | | | | - Mark R Kelley
- Indiana University School of Medicine, Indianapolis, IN
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20
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Oxaliplatin-induced peripheral neuropathy: clinical features, mechanisms, prevention and treatment. J Neurol 2020; 268:3269-3282. [PMID: 32474658 DOI: 10.1007/s00415-020-09942-w] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 02/06/2023]
Abstract
Oxaliplatin (OXA) is a commonly used platinum-based chemotherapy drug for colorectal cancer. OXA-induced peripheral neurotoxcity (OIPN) is a comprehensive adverse reaction of OXA. OIPN can be divided into acute and chronic types according to clinical features and different mechanisms. The main clinical features of acute OIPN are cold-sensitive sensory symptoms and neuropathic pain in limbs. In addition to the above symptoms, chronic OIPN also produces autonomic nerve dysfunction. The most important mechanism involved in acute OIPN is the alteration of voltage-gated Na + channels, and nuclear DNA damage in chronic OIPN. There are some methods like reducing exposure to cold, calcium and magnesium salts, amifostine could be beneficial in acute OIPN prevention and dose modification, changing in schedule glutathione, duloxetine, selective serotonin reuptake inhibitors, carbonic anhydrase inhibitor in chronic OIPN prevention. Recent updates are provided in this article in relation to the clinical features, potential mechanisms, prevention and treatment of OIPN.
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21
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The Effect of Chemotherapy on Balance, Gait, and Falls Among Cancer Survivors: A Scoping Review. REHABILITATION ONCOLOGY 2020. [DOI: 10.1097/01.reo.0000000000000238] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Knoerl R, Gilchrist L, Kanzawa-Lee GA, Donohoe C, Bridges C, Lavoie Smith EM. Proactive Rehabilitation for Chemotherapy-Induced Peripheral Neuropathy. Semin Oncol Nurs 2020; 36:150983. [DOI: 10.1016/j.soncn.2019.150983] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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24
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Monfort SM, Pan X, Loprinzi CL, Lustberg MB, Chaudhari AMW. Exploring the Roles of Central and Peripheral Nervous System Function in Gait Stability: Preliminary Insights from Cancer Survivors. Gait Posture 2019; 71:62-68. [PMID: 31009918 PMCID: PMC6594171 DOI: 10.1016/j.gaitpost.2019.04.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 03/16/2019] [Accepted: 04/05/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Impairments in central and/or peripheral nervous systems are known to be associated with altered gait; however, the interplay between cognitive function, peripheral sensation, and orbital gait stability remains largely unclear. Elucidating these relationships is expected to provide a clearer understanding of potential fall risk factors across various populations and targets for novel interventions. Many patients diagnosed with cancer are treated with chemotherapy agents known to be neurotoxic to the central and/or peripheral nervous systems that can contribute to movement deficiencies, making this population a novel model to investigate these relationships. RESEARCH QUESTION The purpose of this exploratory study was to investigate how central and peripheral nervous system impairments associate with orbital stability during single- and dual-task gait. METHODS Twenty cancer survivors were enrolled and separated into three groups: no prior chemotherapy exposure (CON, n = 6), and prior treatment with chemotherapy and having no/mild chemotherapy-induced peripheral neuropathy (CIPN) symptoms (-CIPN, n = 8) or moderate/severe CIPN symptoms (+CIPN, n = 6). Testing included single- and dual-task (i.e., serial sevens) treadmill walking as well as a computerized test of executive function. Maximum Floquet multipliers were calculated to assess orbital stability during gait. RESULTS Worse executive function was associated with decreased orbital stability during the dual-task condition in the +CIPN group (Spearman's ρ = 0.94, P = 0.017). Additionally, decreased orbital stability during dual-task gait was observed for the -CIPN group compared to the CON group (ES = 1.96, P = 0.019). SIGNIFICANCE Executive dysfunction was associated with decreased gait stability during challenging dual-task gait in survivors with sensory symptoms of CIPN. The association between combined central and peripheral nervous system impairments and decreased gait stability in cancer survivors provides a novel demonstration of potential compensatory strategies that accompany deficiencies in these functions. Future work is needed to confirm these relationships and whether they hold in other populations.
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Affiliation(s)
- Scott M Monfort
- Department of Mechanical and Industrial Engineering, Montana State University, Bozeman, MT, USA; Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, OH, USA.
| | - Xueliang Pan
- Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | | | - Maryam B Lustberg
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Center, The Ohio State University, Columbus, OH, USA
| | - Ajit M W Chaudhari
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, OH, USA; School of Health & Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
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