Lower Levels of Physical Activity Are Associated with Increased Severity of Chemotherapy-Induced Peripheral Neuropathy in Cancer Survivors PDF Download

Author: Anna Wilcoxon
Publisher:
ISBN: 9781083409652
Category :
Languages : en
Pages :

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Book Description
Limited information exists on the effects of self-reported exercise on subjective and objective measures of chemotherapy-induced peripheral neuropathy (CIPN). In this study, we evaluated for differences in demographic and clinical characteristics, as well as subjective and objective measures of CIPN and balance among 290 cancer survivors with CIPN who were classified into one of three exercise (Ex) groups (i.e., NoEx, LessEx, RecEX) based on the recommended level of >150 minutes per week. Survivors completed self-report questionnaires and underwent a sensory examination and balance testing. Compared to RecEx group (34.8%), survivors in the NoEx group (20.7%) had less education, were less likely to be married/partnered, had a lower household income, a higher level of comorbidity, and a poorer functional status. No differences were found among the three exercise groups in duration of CIPN, pain intensity scores, or changes in light touch, cold and pain sensations. However, compared to the RecEx group, survivors in the NoEx group had higher vibratory thresholds and worse scores on objective measures of balance. Based on our "real world" findings, clinicians can recommend walking as a therapeutic option, as well as referrals to physical therapy for additional balance and strength training in survivors with CIPN.

Author: Kerry S. Courneya
Publisher: Springer Science & Business Media
ISBN: 3642042317
Category : Medical
Languages : en
Pages : 389

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Book Description
This book explores in depth the relation between physical activity and cancer control, including primary prevention, coping with treatments, recovery after treatments, long-term survivorship, secondary prevention, and survival. The first part of the book presents the most recent research on the impact of physical activity in preventing a range of cancers. In the second part, the association between physical activity and cancer survivorship is addressed. The effects of physical activity on supportive care endpoints (e.g., quality of life, fatigue, physical functioning) and disease endpoints (e.g., biomarkers, recurrence, survival) are carefully analyzed. In addition, the determinants of physical activity in cancer survivors are discussed, and behavior change strategies for increasing physical activity in cancer survivors are appraised. The final part of the book is devoted to special topics, including the relation of physical activity to pediatric cancer survivorship and to palliative cancer care.

Author: Kathryn H. Schmitz
Publisher: Springer Nature
ISBN: 3030420116
Category : Medical
Languages : en
Pages : 438

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Book Description
This groundbreaking book presents a unique and practical approach to the evolving field of exercise oncology - the study of physical activity in the context of cancer prevention and control. Presenting the current state of the art, the book is sensibly divided into four thematic sections. Following an opening chapter presenting an overview and timeline of exercise oncology, the chapters comprising part I discuss primary cancer prevention, physical activity and survivorship, and the mechanisms by which these operate. Diagnosis and treatment considerations are discussed in part II, including prehabilitation, exercise during surgical recovery, infusion and radiation therapies, and treatment efficacy. Post-treatment and end-of-life care are covered in part III, including cardio-oncology, energetics and palliative care. Part IV presents behavioral, logistical and policy-making considerations, highlighting a multidisciplinary approach to exercise oncology as well as practical matters such as reimbursement and economics. Written and edited by experts in the field, Exercise Oncology will be a go-to practical resource for sports medicine clinicians, family and primary care physicians, oncologists, physical therapy and rehabilitation specialists, and all medical professionals who treat cancer patients.

Author: Robert B. Raffa
Publisher: CRC Press
ISBN: 1439862192
Category : Health & Fitness
Languages : en
Pages : 225

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Book Description
There have been tremendous recent advances in the pharmacotherapy, dose regimens, and combinations used to treat cancer and for the treatment or prevention of the spread of disease. As a direct result of these advances, there are an increasing number of cancer survivors, although research dealing with chemotherapy-induced pain is still in its early

Author: Michael C. Sanders
Publisher:
ISBN:
Category :
Languages : en
Pages : 29

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Book Description
BACKGROUND AND PURPOSE: As survival rates increase among individuals diagnosed with cancer, secondary issues arise post-treatment such as cancer-related fatigue, lymphedema, genitourinary dysfunction, pain and peripheral neuropathies, mainly chemotherapy-induced peripheral neuropathy (CIPN). CIPN typically presents with primarily sensory-related deficits including numbness, tingling, and pain. Studies have shown that the negative consequences of CIPN can be quite significant and result in a marked decrease in quality of life, functional abilities, ambulation and an increase in fall risk. The purpose of this case report is to describe the comprehensive physical therapy management of a patient diagnosed with CIPN following bilateral mastectomy with left axillary lymph node resection and chemotherapy with taxane agents, completed six months prior to physical therapy evaluation. CASE DESCRIPTION: The patient was a 52 year old Caucasian female who was referred to physical therapy for management of CIPN associated pain, balance and functional deficits. The patient reported numbness, tingling, and pain in bilateral feet, rating pain at a 4/10 at rest and 7/10 with increased activity. Patient reported occasional dizziness when fatigued and a decline in balance during ADL-related task and positional changes especially notable in low light situations. Sensory organization testing (SOT) on the NeuroCom system revealed deficits in conditions #5 and #6 with a composite score of 68; 3% below age norms. Patient reported difficulty with stairs, floor transfers and relied on upper extremities for balance with sit to stand transfers. She was unable to complete her custodial job due to deficits. Interventions included a trial of TENS and a referral for Calmare pain therapy or ?scrambler therapy?, manual lymph drainage and compression garments for lymphedema management, and dynamic balance activities including the use of unstable surfaces, narrow base of support conditions, eyes open/eyes closed conditions, and incorporation of head turns with functional activities. OUTCOMES: The patient requested to be discharged on her 9th physical therapy session stating that she felt she had made significant progress in both her balance, restoration of functional abilities and reduction of bilateral foot pain which she rated 3-4/10 with activity. Patient reported being pain free for 24-36 hours after ?Scrambler Therapy?. Furthermore, the patient cited no dizziness or perception of instability in low light settings or during positional changes. The patient also demonstrated improvements from 37-71 on the vestibular component. She was also able to return to work. DISCUSSION: This patient progressed well throughout physical therapy and presented with findings that warrant further research. Specifically, this report agrees with a study by Wampler et al reporting that postural instability in breast cancer survivors was likely due to the patients’ inability to appropriately use their vestibular input. Although no studies report vestibular toxicity following taxane use there has been research suggesting a vestibular component to those patients post-chemo treatment who presented with postural instability. Finally, the few studies published regarding the efficacy of ?Scrambler? therapy in patients with CIPN have shown promising results. The patient in this case report benefitted from the use of this pain modality.

Author: Maryam Lustberg
Publisher: Springer Nature
ISBN: 3030786633
Category : Medical
Languages : en
Pages : 265

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Book Description
This book comprehensively examines chemotherapy-induced peripheral neuropathy (CIPN), a common dose-limiting condition that negatively affects both the quality of life of cancer patients and disease outcomes. CIPN remains a challenging area for both clinical care and research, as there are multiple unresolved issues. Written by leading international experts, the book discusses the natural history of CIPN, the latest predictors of toxicity, instruments for evaluating symptoms, and prevention/therapeutic strategies, as well as patients’ experiences of this common clinical syndrome. Lastly it highlights avenues for future research to enhance our understanding of CIPN. Providing essential information on the management of CIPN and the latest research in the field, this book is a valuable resource for researchers and healthcare providers working with patients with various malignant diseases.

Author: John Saxton
Publisher: Springer Science & Business Media
ISBN: 1441911731
Category : Medical
Languages : en
Pages : 254

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Book Description
An increasing number of exercise scientists are applying their skills collaboratively (with medics and physiotherapists) to clinical populations and investigating the effects of exercise in relation to wide-ranging clinical, pathophysiological and psycho-social outcomes. The book is aimed at final year Undergraduate and Master's level students of Exercise Science, who are interested in working with clinical populations such as cancer patients. Many university Sport and Exercise Science courses in the UK and USA now have modules which are focused on exercise for health, and cover aspects of exercise science which are appropriate for clinical populations. The book would also be a very valuable resource for Undergraduate and Postgraduate Physiotherapy courses and a very useful resource for students of Exercise Science and Physiotherapy, as well as practitioners working with cancer patients.There are an increasing amount of research opportunities for exercise scientists who are interested in working with clinical populations. Furthermore, a considerable amount of Government and Charity research funding is being targeted at active lifestyles and this is helping to generate a new culture of collaboration between exercise scientists and medics. Hence, it is highly likely that an increasing number of students from Sport and Exercise Science courses will pursue careers within the clinical realm in the future. Practicing exercise therapists, clinical exercise physiologists and physiotherapists would also find lots of useful up-to-date knowledge to support their evidence-based clinical practice. This book would also be of interest to informed readers who are themselves undergoing or recovering from cancer treatment.

Author: Mohamedtaki Tejani
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Book Description
INTRODUCTION: Over half of patients receiving taxane, platinum, or bortezomib chemotherapy experience CIPNu2014a dose-limiting toxicity with numbness, pain, and muscle problems in the extremities. This randomized pilot study explored whether exercise improves CIPN symptoms and physical function.METHODS: Nineteen patients to receive taxane, platinum, or bortezomib were randomized to exercise (home-based, low-moderate-intensity, walking+resistance training; EXCAPu00a9u00ae) or nutrition education (control) for 12 weeks upon first infusion. At 0, 6, and 12 weeks, we assessed CIPN symptoms via CIPN-20 sensory scale (9-36, higher is worse). We assessed physical function via leg strength (Biodex) and six-minute walk. Linear regression modeled each outcome, tested for effects of exercise, and controlled for baseline and age because controls were older. Because this is a pilot study, we present effect sizes, not p-values.RESULTS: The 19 patients were 65u00b111 years, 52% women, with cancer: 42% breast, 32% gastrointestinal, 16% myeloma, 10% genitourinary. Exercise mitigated CIPN symptoms. At 6 weeks, exercisers increased 11.0 to 12.5 whereas controls increased 11.0 to 15.5 (+1.5 vs. +4.5; ES=0.81). At 12 weeks, exercisers increased 11.0 to 14.8 whereas controls increased 11.0 to 16.2 (+3.8 vs. +5.2, ES=0.46). Exercisers improved leg strength vs. controls (ES=0.35 and 0.28 at 6 and 12 weeks) and six-minute walk distance at 6 weeks vs. controls (1,721 vs. 1,631 ft; ES=0.22) but walked slightly less than controls at 12 weeks (1,679 vs. 1,705; ES=-0.16).CONCLUSION: Exercise during neurotoxic chemotherapy mitigated CIPN symptoms and improved physical function. Future work should test for replication with a larger sample. NCT03021174.

Author: Daryl I. Smith
Publisher: Springer Nature
ISBN: 3030914550
Category : Medical
Languages : en
Pages : 294

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Book Description
This comprehensive source on the pathogenic origins of neuropathic pain covers the detailed molecular bases of the currently known neuropathies as classified by their pathogenic origins. Filling a critical need, this book fills the need for a resource on a syndrome that demands improved understanding by clinicians and researchers alike so that treatment options for patients are not categorically limited to a pill or a needle. If the clinician understands the origins of a patients' neuropathic pain, they can work cooperatively toward improving it with tailored therapies that don't create societal diseconomies and that ultimately are effective in helping patients. The book presents in detail the molecular bases of some currently known neuropathies by their pathogenetic origins, allowing clinicians to tailor more specific and more effective treatment regimens for their patients. For basic researchers, this book is a general resource to better direct research on neuropathy-specific molecular mechanisms. The improved understanding of the pathogenesis of neuropathic pain can then be used to develop more specific and more effective manipulations of these pathways.

Author: Elizabeth R Andersen Hammond
Publisher:
ISBN:
Category :
Languages : en
Pages : 0

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Book Description
Chemotherapy induced peripheral neuropathy (CIPN) can have lasting sensory effects for cancer survivors. At present, the mechanisms causing the neuropathy are unknown and few effective treatment options are available. This thesis includes a review of the literature and four studies. The first study evaluated the potential role for physical therapy and nerve gliding home exercises to improve symptoms of CIPN and explored whether a dual nerve disorder was present between the surgical and non-surgical side in a population with breast cancer. The nerve gliding exercises had a positive effect on pain as measured by the numeric pain rating scale (NPRS) and pain pressure algometry. No quantitative sensory testing (QST) data could identify a possible dual nerve disorder from surgery combined with chemotherapy. The second trial sought to confirm the effectiveness of electro acupuncture on improving chronic neuropathic pain from CIPN. This trial showed the ineffectiveness of electro acupuncture for chronic CIPN pain symptoms. The third study used the physical therapy study data to define the sensory phenotypes of neuropathic and non-neuropathic symptom profiles. This was completed to identify future targets for mechanism-based treatment. Surprisingly, only left hand heat pain threshold differences were observed on the QST measures. As expected, increased pain (measured by the NPRS) and decreased function (measured by the Disability of the Shoulder, Arm and Hand (DASH)) were observed in the neuropathic group. Using the physical therapy data, the fourth study correlated active participants with preservation of nerve function exploring the possible neuroprotective effect of exercise on CIPN. 'Active' versus 'less active' groups revealed significantly improved vibration perception and normalized heat pain thresholds for the active group suggesting possible neuroprotection among exercisers. This thesis helps to direct evidence-based practice and contributes to the literature. Our findings indicate that electro acupuncture should not be pursued as a treatment option for patients experiencing chronic pain from CIPN. Our findings support the use of physical therapy, nerve gliding exercises, and general exercise during and after chemotherapy. Physical therapy and nerve gliding exercises help reduce the symptoms associated with chemotherapy induced peripheral neuropathy while maintaining physical activity throughout treatment may provide neuroprotection.