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Tomanovic Vujadinovic S, Ilic N, Selakovic I, Nedeljkovic U, Krstic N, Mujovic N, Dubljanin Raspopovic E, Jovanovic D. TENS Improves Cisplatin-Induced Neuropathy in Lung Cancer Patients. Medicina (Kaunas) 2022; 58:medicina58101405. [PMID: 36295566 PMCID: PMC9611034 DOI: 10.3390/medicina58101405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/07/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022]
Abstract
Background: Cisplatin-induced peripheral neuropathy is a common complication of cisplatin therapy, which develops in most patients with lung cancer. There are no effective preventive measures and once it occurs there is no effective therapy, except symptomatic. In this study, we aimed to assess the effect of transcutaneous electrical nerve stimulation (TENS) therapy on the pain intensity and the quality of life of patients with cisplatin-induced neuropathy. Material and Methods: A prospective cohort study was performed from 2013 to 2018, at the Clinical Center of Serbia. After the initial evaluation of 106 newly diagnosed patients with lung cancer, 68 patients did not have peripheral neuropathy. These 68 patients continued in the study and started the cisplatin chemotherapy. Forty of these patients developed cisplatin-induced neuropathy, which was manifested by neuropathic symptoms and proven by ENG examination. All patients with cisplatin-induced neuropathy were treated with TENS therapy. Their neuropathic pain and quality of life were evaluated using the following questionnaires at diagnosis, after cisplatin therapy and after four weeks of TENS use: DN4, VAS scale, EORTC QLQ-C30 and FACT-L. Results: Two thirds (68%) of the patients with cisplatin-induced neuropathy were male and the majority were smokers (70%). Adenocarcinoma was the most common (38%), followed by squamous (33%) and small-cell carcinoma (28%). The application of TENS therapy had a positive effect on reducing the neuropathic pain and increasing the quality of life for patients with painful cisplatin-induced neuropathy. The VAS and DN4 scores significantly decreased after TENS therapy, in comparison to its values after cisplatin therapy (p < 0.001). After TENS therapy, patients had significantly higher values in most of the domains of EORTC QLQ-C30 and FACT- L, in comparison with the values after cisplatin therapy (p < 0.001). Conclusion: The application of TENS therapy has a positive effect on reducing neuropathic pain and increasing the quality of life for patients with lung cancer and cisplatin-induced neuropathy.
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Affiliation(s)
- Sanja Tomanovic Vujadinovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Center for Physical Medicine and Rehabilitation, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Correspondence:
| | - Nela Ilic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Center for Physical Medicine and Rehabilitation, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Ivan Selakovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Center for Physical Medicine and Rehabilitation, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Una Nedeljkovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Center for Physical Medicine and Rehabilitation, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Nevena Krstic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Center for Physical Medicine and Rehabilitation, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Natasa Mujovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Center for Physical Medicine and Rehabilitation, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Emilija Dubljanin Raspopovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Center for Physical Medicine and Rehabilitation, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Dragana Jovanovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Clinic of Pulmonology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
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Selakovic I, Dubljanin-Raspopovic E, Markovic-Denic L, Marusic V, Cirkovic A, Kadija M, Tomanovic-Vujadinovic S, Tulic G. Can early assessment of hand grip strength in older hip fracture patients predict functional outcome? PLoS One 2019; 14:e0213223. [PMID: 31369561 PMCID: PMC6675283 DOI: 10.1371/journal.pone.0213223] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 07/20/2019] [Indexed: 01/13/2023] Open
Abstract
Decreased muscle strength is not only a risk factor for hip fracture in older patients, but plays a role in recovery of physical function. Our aim was to assess the role of grip strength measured early after hip fracture, and classified according to the EWGSOP2 criteria in predicting short- and long-term functional recovery. One hundred ninety-one patients with acute hip fracture consecutively admitted to an orthopaedic hospital have been selected. A multidimensional geriatric assessment evaluating sociodemographic variables, cognitive status, functional status and quality of life prior to fracture, as well as perioperative variables were performed. Follow-ups at 3 and 6 months after surgery were carried out to evaluate functional recovery. Multivariate regression models were used to assess the predictive role of handgrip strength. The mean age of the participants was 80.3 ±6.8 years. Thirty-five percent of our patients with clinically relevant hand grip strength weakness were significantly older, more often female, had a lower BMI, and were of worse physical health. They also had a lower cognitive level, lower Barthel index, and lower EQ5D scores before fracture. Multivariate regression analysis adjusted for age and gender revealed that hand grip weakness was an independent predictor of worse functional outcome at 3 and 6 months after hip fracture for both genders and in all age populations. Our study supports the prognostic role of hand grip strength assessed at hospital admission in patients with hip fracture. Thus, clinicians should be encouraged to include hand grip assessment in their evaluation of hip fracture patients in the acute setting in order to optimize treatment of high-risk individuals.
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Affiliation(s)
- Ivan Selakovic
- Clinic for Physical Medicine and Rehabilitation, Clinical Center of Serbia, Belgrade, Serbia
- * E-mail:
| | - Emilija Dubljanin-Raspopovic
- Clinic for Physical Medicine and Rehabilitation, Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ljiljana Markovic-Denic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vuk Marusic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Andja Cirkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Department for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marko Kadija
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute for Orthopaedic Surgery and Traumatology, Clinical Center of Serbia, Belgrade, Serbia
| | - Sanja Tomanovic-Vujadinovic
- Clinic for Physical Medicine and Rehabilitation, Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Goran Tulic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute for Orthopaedic Surgery and Traumatology, Clinical Center of Serbia, Belgrade, Serbia
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