Evaluation of the effects of sensorimotor exercise on physical and psychological parameters in breast cancer patients undergoing neurotoxic chemotherapy

J Cancer Res Clin Oncol. 2018 Sep;144(9):1785-1792. doi: 10.1007/s00432-018-2686-5. Epub 2018 Jun 25.

Abstract

Introduction: Breast cancer is the most common cancer disease of women in industrialized countries. Neurotoxic chemotherapy drugs are known to harm peripheral nerves and cause a chemotherapy-induced peripheral neuropathy (CIPN). CIPN is one of the most common adverse events associated with Paclitaxel chemotherapy and may remain present long after the termination of chemotherapy. Thus, it reduces the patients' quality of life (QoL) both during chemotherapy and onwards, and can impose a danger on breast cancer survivors due to an increased risk of falling and fall-related injuries.

Methods: The aim of this randomized-controlled trial (RCT) (n = 36) (IG: intervention group, n = 17) (CG: control group, n = 19) was to determine whether sensorimotor exercises have a positive effect on physical and psychological parameters in breast cancer patients undergoing neurotoxic chemotherapy (Paclitaxel).

Results: As a result, we were able to show significant improvements in postural stability in monopedal stance [left leg 16.17 ± 3.67 vs. 21.55 ± 5.33 (p < 0.001) and right leg 15.14 ± 2.30 vs. 20.85 ± 5.05 (p < 0.001)] and in bipedal stance [T1 vs. T0, - 0.49 (IG) vs. + 1.14 (CG) p = 0.039].

Discussion: These results in posturography correlate with the clinical presentation with intervention group patients scoring significantly better on the Fullerton Advanced Balance Scale [37.71 ± 2.73 vs. 34.47 ± 3.98 (p = 0.004)]. Moderate strength training successfully prevented a strength loss in the IG that was remarkable in the CG (- 1.60 vs. 0.60, p = 0.029). Concerning the psychological parameters assessed via EORTC- and MFI-questionnaires, no significant improvements were found.

Conclusion: Future studies should focus on the correlation of clinical and posturometry findings and subjective QOL such as the long-term-development of CIPN.

Keywords: Adverse events; BR-23; Bipedal stance; Breast cancer; CIPN-20; Chair rising test; Chemotherapy; Chemotherapy-induced peripheral polyneuropathy; Eortc; European organization of research and treatment of cancer; Exercise intervention; FAB; Fall risk; Fullterton Advanced Balance Scale; Hand dynamometer; Lower extremity; MFI-20; Mamma-carcinoma; Monopedal stance; Multidimensional Fatigue Inventory; Nerves; Neuropathy; Neurotoxic; Paclitaxel; Postural instability; Posturography; Posturometry; QLQ-C30; Qol; Quality of life; Risk of falling; Sensorimotor exercise; Strength; Survivors; Sway area; Taxol; Training; Upper extremity.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / physiopathology*
  • Breast Neoplasms / psychology*
  • Case-Control Studies
  • Exercise / physiology*
  • Female
  • Humans
  • Middle Aged
  • Paclitaxel / therapeutic use
  • Peripheral Nervous System Diseases / chemically induced*
  • Peripheral Nervous System Diseases / physiopathology*
  • Peripheral Nervous System Diseases / psychology
  • Quality of Life
  • Sensorimotor Cortex / physiopathology*
  • Survivors
  • Young Adult

Substances

  • Antineoplastic Agents
  • Paclitaxel