PTOtherGait & posture2019

Exploring the Roles of Central and Peripheral Nervous System Function in Gait Stability: Preliminary Insights from Cancer Survivors.

Scott M Monfort, Xueliang Pan, Charles L Loprinzi and 2 others

PMID 31009918

WHAT IT FOUND

Cancer survivors with chemotherapy and no to mild neuropathy symptoms showed worse dual-task treadmill stability than controls.

In those with moderate to severe neuropathy, stability tracked executive function, but they did not differ significantly from controls.

Key findings

01During dual-task treadmill walking, the chemotherapy group with no to mild neuropathy symptoms had decreased orbital stability at initial contact compared with controls (ES = 1.96, P = 0.019) and compared with the moderate to severe neuropathy group (ES = 1.43, P = 0.029).

02In the moderate to severe neuropathy group, worse executive function was associated with improved single-task orbital stability (maxFM_all rho = -0.94, P = 0.017; maxFM_IC rho = -1.00, P = 0.003) and with a larger drop in stability when the counting task was added (maxFM_all rho = 0.94, P = 0.017).

03The moderate to severe neuropathy group did not differ significantly from controls during dual-task walking at initial contact (ES = 1.35, P = 0.082), and stability differences were not seen during single-task walking.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study included only 20 participants, so it was exploratory and could not support firm conclusions. The authors did not correct for multiple comparisons, so some significant findings may be chance. The paper states the primary outcome was maze test errors, but the supplied text does not report that result. Falls were not measured, so the link from orbital stability to real fall risk was not established. Walking was on a fixed-speed treadmill, which suppresses real-world adaptations such as slowing down. Two participants with moderate to severe neuropathy had to repeat the dual-task trial after drifting toward the back of the treadmill, which may have altered their strategy. One control participant's dual-task data were excluded after marker loss, and one participant did not perform the assigned counting task. The groups were not randomly assigned; they were formed by diagnosis, treatment, and questionnaire scores.

Declared interests

The authors declared no conflicts of interest.

The easy way to misread this

Do not conclude that chemotherapy-induced neuropathy causes falls or that dual-task instability is proven. This was a small exploratory study with no fall outcomes, no correction for multiple comparisons, and the moderate to severe neuropathy group did not differ significantly from controls.

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