A review of movement disorders in chemotherapy-induced neurotoxicity.
Allison B Wang, Stephen N Housley, Ann Marie Flores and 3 others
PMID 33494755WHAT IT FOUND
Cancer survivors with chemotherapy-induced neurotoxicity show excessive side-to-side sway, slower shorter steps, and jerky grasping.
These objective movement deficits link to sensory loss but may also involve weakness or vision reliance, requiring targeted assessment beyond patient reports.
Key findings
01Cancer survivors with chemotherapy-induced neurotoxicity exhibit greater postural sway, particularly in the mediolateral direction, compared to healthy controls.
02Gait patterns in this population are conservative, characterized by slower speed, shorter step length, and increased double support time.
03Upper limb function is impaired, specifically showing decreased smoothness during grasping and increased pen pressure during writing tasks.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a narrative review, not a systematic review or meta-analysis, so the selection of studies was not blinded or strictly protocolized, introducing potential selection bias. The included studies used highly heterogeneous assessment tools and populations (mixed cancer types, varying time since treatment), making direct comparison or pooling of results impossible. Most studies did not control for other common side effects like fatigue, pain, or cognitive changes, which could independently contribute to the observed movement deficits. There is a lack of data on adult populations for some findings, such as ankle musculoskeletal changes, which were primarily observed in pediatric cohorts. Few studies rigorously tested visual or vestibular systems, leaving the relative contribution of these factors to balance deficits unclear.
Declared interests
The work was supported by the National Cancer Institute and the National Institutes of Health. The authors declared no other conflicts of interest.
The easy way to misread this
Do not assume these movement deficits are caused solely by peripheral sensory neuropathy. The review highlights that weakness, visual reliance, and cognitive factors may also contribute, and current evidence cannot isolate the specific cause of the disability in individual patients.