Study Overview:

• Publication Date: July 2024
• Research Timeline: Conducted from May 2014 to November 2020, with data analyzed in June 2021.

This study evaluated the effects of sensorimotor training (SMT) and whole-body vibration (WBV) training on reducing the incidence and severity of chemotherapy-induced peripheral neuropathy (CIPN).

Purpose of the Study:

CIPN is a common adverse effect of chemotherapy, impacting patient quality of life and potentially limiting treatment options. This study aimed to explore whether SMT and WBV could prevent CIPN by enhancing neuromuscular function, reducing neuropathic symptoms, and improving overall patient outcomes.

Participant Details:

• Population Studied:
  • 158 adult patients undergoing chemotherapy with neurotoxic agents (oxaliplatin or vinca alkaloids).
  • Mean age: 49.1 years (range: 18–82).
  • 58.9% were male.
• Exclusion Criteria:
  Patients with preexisting neuropathy, severe cardiovascular conditions, or prior chemotherapy were excluded.

Intervention and Methods:

• Study Design:
  Participants were randomized into three groups: SMT (n = 55), WBV (n = 53), or treatment as usual (TAU, n = 50).
• Training Protocols:
  • SMT: Balance exercises on unstable surfaces, progressively increasing in difficulty.
  • WBV: Sessions on a vibration platform targeting proprioceptive stimulation.
  • TAU: Standard medical care without specific exercise interventions.
• Duration and Frequency:
  Two supervised sessions per week, each lasting 15–30 minutes, conducted during chemotherapy treatment.
• Outcome Measures:
  • Incidence of CIPN.
  • Balance control, neuropathy symptoms, quality of life, and chemotherapy-related dose reductions.

Key Findings:

• Reduction in CIPN:
  • SMT reduced CIPN incidence to 30% (from 70.6% in TAU).
  • WBV reduced CIPN incidence to 41.2%.
• Improved Balance and Sensory Function:
  • Patients in SMT showed significant improvements in vibration sensitivity, touch sensation, and balance control.
  • WBV participants improved in bipedal stance stability.
• Lower Chemotherapy Dose Reductions and Mortality:
  • SMT participants required fewer dose reductions due to neuropathy and had lower mortality rates compared to TAU.
• Improved Quality of Life:
  Both SMT and WBV improved physical activity levels and health-related quality of life, though these results were not statistically significant.

Implications and Importance:

This trial demonstrates that neuromuscular training interventions can significantly mitigate CIPN and improve functional outcomes for cancer patients. These findings suggest that SMT, in particular, may enhance chemotherapy tolerance and survival by maintaining neuromuscular and sensory function.

Takeaway Message:

Neuromuscular training, such as SMT and WBV, offers a promising approach to preventing CIPN and enhancing quality of life for chemotherapy patients. Integrating these interventions into cancer care has the potential to improve treatment adherence and long-term patient outcomes.

Reference for Further Reading:

Streckmann, F., Elter, T., Lehmann, H. C., et al. (2024). Preventive Effect of Neuromuscular Training on Chemotherapy-Induced Neuropathy: A Randomized Clinical Trial. JAMA Internal Medicine, 184(9), 1046–1053. https://doi.org/10.1001/jamainternmed.2024.2354.