Custom Orthotics to Mitigate Effects of Chemotherapy-induced Peripheral Neuropathy

Area of Science:

• Neurology
• Biomechanics
• Rehabilitation

Background:

• Chemotherapy-induced peripheral neuropathy (CIPN) often causes balance and gait deficits due to diminished proprioception, increasing fall risk.
• Current evidence does not support orthotic use for CIPN-related balance dysfunction.

Purpose of the Study:

• To describe the use of custom foot orthotics with a foam overlay to enhance postural stability and mobility in a patient with CIPN.
• To evaluate the effectiveness of orthotics in improving balance and gait in CIPN.

Main Methods:

• A patient with progressive balance dysfunction secondary to CIPN received custom foot orthotics.
• Computerized dynamic posturography and accelerometry measured postural sway under three conditions: barefoot, shoes only, and shoes with orthotics.
• Timed Up and Go and gait speed tests were also administered.

Main Results:

• Orthotic use led to improvements in sway velocity and area, indicating enhanced postural stability.
• The patient demonstrated improved ability to stand unassisted and better performance on Timed Up and Go and gait speed tests.
• These findings suggest custom orthotics can positively impact balance and mobility in CIPN patients.

Conclusions:

• Custom foot orthotics may be a viable intervention for improving balance and mobility in individuals with CIPN.
• Further research is warranted to validate these findings in a larger cohort and explore optimal orthotic designs for CIPN.
• This case highlights a potential non-pharmacological approach to managing CIPN-related functional deficits.