Proactive Rehabilitation for Chemotherapy-Induced Peripheral Neuropathy.
Robert Knoerl, Laura Gilchrist, Grace A Kanzawa-Lee and 3 others
PMID 31959510WHAT IT FOUND
Screen oncology patients for motor deficits using simple tests like the Five Times Sit-to-Stand or Timed Up and Go.
Refer to physical or occupational therapy early to address balance and dexterity issues. Recommend exercise to help manage chemotherapy-induced neuropathy.
Key findings
01Objective motor tests such as the Five Times Sit-to-Stand and Timed Up and Go can identify functional mobility deficits and fall risk in patients with chemotherapy-induced peripheral neuropathy.
02Exercise interventions, particularly those combining aerobic, strength, and balance training, have shown improvements in neuropathy symptoms and physical function in reviewed studies.
03Patients with upper extremity deficits affecting daily tasks like writing or buttoning should be referred to occupational therapy, while those with lower extremity or balance issues require physical therapy.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
The reviewed studies on exercise interventions had small sample sizes, lacked blinding, and used heterogeneous protocols, limiting the certainty of the evidence. No single gold-standard assessment tool exists for chemotherapy-induced peripheral neuropathy, and many measures have not been validated specifically in this population. The review does not report new primary data but synthesizes existing literature, which may include publication bias.
Declared interests
Dr. Knoerl reports a consulting honorarium from System Analytic. The other authors have no conflicts of interest to disclose.
The easy way to misread this
Do not interpret the positive findings on exercise and rehabilitation as proof of efficacy for specific protocols. The evidence base consists of small, heterogeneous studies, so interventions should be tailored to individual patient needs and deficits rather than applied as a standard cure.