Gait as a quantitative indicator of the severity of chemotherapy-induced peripheral neuropathy: a pilot study

Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent and debilitating side effect of neurotoxic chemotherapeutic agents. Patient-reported outcome (PRO) measures are widely utilized to assess CIPN severity; however, they are subject to bias and variability. This prospective case series investigates whether gait parameters provide an objective measure of CIPN severity. This pilot study consisted of 27 patients: 9 active CIPN, 9 CIPN resolved, and 9 healthy controls. Gait parameters including velocity, ambulation time, cadence, distance, and number of steps were assessed using GAITRite®. Treatment-Induced Neuropathy Assessment Scale (TNAS) pain and PROMIS® 29 + 2 Profile v2.1 (PROPr) scores were collected and correlated with gait measures. Patients with active CIPN exhibited significant gait impairments compared to both CIPN-resolved and healthy control groups. Active CIPN patients exhibited significantly slower velocity, greater step count, shorter walking distance, and longer ambulation time as compared to both CIPN-resolved and healthy control groups. Active CIPN patients also had higher cadence than healthy controls. TNAS pain scores were significantly negatively correlated with velocity and positively correlated with ambulation time in active CIPN patients. PROPr domains (pain intensity, pain interference, and physical function) were significantly correlated with velocity and ambulation time. Our preliminary findings demonstrate the potential for gait parameters to serve as an objective and relatively quick method for assessing CIPN severity. Further studies with a larger and more diverse sample will be necessary to establish gait as a clinical tool for evaluating severity, functional decline, and recovery in cancer survivors.