Feasibility study for helping patients with chemo-induced peripheral neuropathy

Feasibility study on balance and cognitive training for patients with chemo-induced peripheral neuropathy.

• Topic: Combination of cancers
• Institution: Neuroscience Research Australia
• Country: Australia
• Status: Ongoing

Researcher: Jasmine Menant

Grant title: Integrated balance and cognitive training to improve symptoms, balance and quality of life in cancer survivors with chemotherapy-induced peripheral neuropathy: a feasibility study

We are grateful to receive funding from Cancer Australia and World Cancer Research Fund to investigate a novel home-based rehabilitation programme in cancer survivors with chemotherapy-induced peripheral neuropathy. Our study will explore the intervention’s uptake and adherence, motivations to exercise participation as well the effectiveness of the program to reduce symptoms, improve balance and quality of life. As such our cognitive-motor step training programme has the potential to significantly improve the lives of cancer survivors exposed to neurotoxic chemotherapy – Dr Jasmine Menant

Background

Chemotherapy-induced peripheral neuropathy (CIPN) is a major adverse side-effect of cancer treatment producing nerve damage in the hands and feet. Cancer survivors with CIPN report numbness, tingling and pain, resulting in impaired sensation which dramatically affects balance and walking ability. Difficulties concentrating, making fast decisions, doing 2 tasks at once and remembering things are also reported by up to 30% of cancer survivors, irrespective of their treatment.

Our recent study showed that cancer survivors with CIPN make slower and less consistent steps than healthy peers when they are concurrently challenged by thinking tasks. This finding is concerning because:

1. fast and accurate steps are necessary to avoid hazards when walking, as well as to recover balance (eg after a slip or trip) and avoid falling.
2. the ability to do 2 things at once is an essential component of everyday life activities.

Aims and objectives

We will investigate whether cancer survivors with CIPN enjoy playing “brain training” games involving stepping responses on a computerised mat as well as whether they adhere to the recommended weekly training dose. We will also determine whether our interactive stepping programme can improve symptoms’ burden, balance and walking and ultimately improve the quality of life of cancer survivors with CIPN.

How it will be done

We will recruit 44 volunteer cancer survivors with CIPN aged ≥18 years. We will install stepping mats in their homes and teach them how to safely play the games (“exergames”) at a recommended dose of 80 to 120min/week for 16 weeks. We will encourage participants to play exergames of increasing complexity to maintain balance and thinking challenges. We will assess all participants’ balance, stepping and walking as well as survey their quality of life, before and after the 16-week trial. We will also interview a subset of participants regarding their satisfaction with the programme.

Potential impact

If successful, our training programme has the potential to significantly improve the quality of life of cancer survivors with CIPN by enabling them to perform complex activities of everyday life involving balance and walking. This is turn is likely to increase participation in physical and social activities. The findings of this study will also guide our further research:

1. to generalise the use of this exercise programme among this clinical group.
2. to determine if this rehabilitation intervention can reduce neuropathy symptoms and improve quality of life in this vulnerable population.