Supportive care: Comparing exercise interventions for upper extremity polyneuropathy induced by chemo- or...

Area of Science:

• Oncology
• Neurology
• Rehabilitation Medicine

Background:

• Peripheral neuropathy (PNP) affects up to 68% of cancer patients due to chemotherapy and immunotherapy, often persisting post-treatment and impacting quality of life.
• While exercise benefits lower-limb PNP, evidence for upper-extremity symptoms is limited.
• The VISCIPH B pilot study explored supervised exercise interventions for upper-extremity PNP.

Purpose of the Study:

• To assess the feasibility, safety, and efficacy of two supervised exercise interventions for cancer patients with upper-extremity peripheral neuropathy.
• To compare the effects of combined sensorimotor plus vibration exercise (PNPEX) versus moderate resistance exercise (MREX).

Main Methods:

• A single-center randomized controlled pilot trial involving 61 cancer patients with symptomatic upper-extremity PNP.
• Participants were randomized to PNPEX or MREX, with supervised sessions twice weekly for 12 weeks.
• Feasibility outcomes included adherence, retention, and safety. Symptom outcomes were measured using FACT/GOG-Ntx, NRS pain scale, Rydel-Seiffer tuning fork, and EORTC QLQ-C30 quality of life questionnaire.

Main Results:

• High adherence (86%) and retention (69%) were observed, with no intervention-related adverse events.
• The PNPEX group showed significantly greater improvement in FACT/GOG-Ntx scores compared to MREX (p=0.05).
• PNPEX participants reported significant improvements in numbness, tingling, depth sensitivity, and global health (p=0.001).

Conclusions:

• Supervised exercise, specifically combined sensorimotor and vibration exercise, is feasible, safe, and well-accepted for managing upper-extremity PNP in cancer patients.
• This intervention demonstrated meaningful reductions in PNP symptoms and functional improvements.
• Larger trials are recommended to further validate these findings.