Exercises for Patients Who Were Receiving Chemotherapy
Condition: Chemotherapy-induced Peripheral Neuropathy
MeSH terms: Peripheral Nervous System Diseases
Study type: Interventional

Summary: 
      To evaluate the effect of lower extremity strengthening and balance exercises on balance,
      quality of life and neuropathic pain of the cancer patients receiving neurotoxic
      chemotherapy.
    

Detailed description: 
      Cancer-related mortality rates decreased considerably thanks to novel treatment methods and
      new agents over the last two decades. Although chemotherapy (CT) is an effective treatment
      type in reducing the size of the tumor and eliminating metastases, it may harm many different
      organs and systems due to short & long-term side effects. Peripheral neuropathy (PN) is
      regarded as a neurological and clinical side effect for cancer patients. PN may arise as a
      paraneoplastic symptom but more commonly occurs with neurotoxic CT agents. Short & long-term
      side effects that may damage sensory, motor, and autonomic neurons. This damage to the
      small-fiber sensory nerves causes a change in the sense of touch, pain, and warmth, while the
      damage to the large-fiber nerves causes a change in the sense of vibration and
      proprioception. Motor nerve damage affects voluntary movement, muscle tone, and coordination,
      and damage to the autonomic nervous system affects intestinal motility and blood pressure
      over smooth muscles. Despite the fact that studies on PN treatment have generally focused on
      pharmacological agents reducing pain or treating selected side effects, no agent that may be
      preventive for chemotherapy induced Peripheral Neuropathy (CIPN) due to neurotoxic
      chemotherapy has been recommended in the review of the American Society of Clinical Oncology.

      Side effects due to CT such as anorexia, nausea, vomiting, mucositis, diarrhea, anemia or PN
      may lead to impairment in the quality of life of the patient and may significantly reduce the
      level of physical activity. Neurotoxic and ototoxic effects may cause ataxia, paresthesia and
      dysesthesia, leading to gait, and balance disorders. CIPN has been associated with balance
      disorder, loss of function and reduced quality of life in the literature. It may result in
      loss of balance, difficulty in ambulation, increase in the frequency of collapse and
      accordingly increase in injuries. Despite the fact that medical treatments used in CIPN are
      often helpful in the treatment of neuropathic pain, no effect has been observed on muscle
      strength, gait, and balance. It is believed that muscle strength and balance exercises, such
      as aerobic exercises, can provide mitochondria with oxygen and glucose by increasing blood
      supply, thereby contributing to energy production and reducing symptoms. Current data suggest
      that exercise is applicable, safe, and beneficial for this group of patients. Balance
      exercises at an early stage may prevent or delay the onset of sensory and motor symptoms.
      Although exercise is accepted as a supportive treatment, which should be addressed more
      seriously for a patient population with PN, there is not enough information in the literature
      on timing, frequency, and mode of administration of the treatment program that will be
      carried out in this specific group of patients.

      The aim of this study is to investigate the effects of therapeutic exercise program including
      concurrently initiated strengthening, balance and aerobic exercises on the symptoms, balance
      status and quality of life of the group of patients who have a limited physical activity, a
      risk of developing PN following the treatment, and will have a long-term bed rest and compare
      with the group of patients not receiving any exercise program in the same treatment period.
    

Intervention name(s): Exercise
Intervention type(s): Other
Intervention description(s): Strengthening, balance and aerobic exercises were explained to the patients examined before chemotherapy sessions and demonstrated by applying on the patient.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Supportive Care
Keywords: cancer; chemotherapy; peripheral neuropathy; exercise