In spite of the frequency of peripheral neuropathy, only minimal information is available to health care professionals on assessing this disorder, educating patients regarding care and planning interventions and referrals to assist management. Sensory and motor nerves are the two main types of nerves involved in chemotherapy-induced peripheral neurotoxicity. Sensory nerves are responsible for conscious sensation, touch, pain, temperature, position and vibration. When sensory nerve stimulation is decreased or absent, injuries may occur. For example, patients are unable to grip objects due to numbness in the fingers, fail to respond to dangerous situations due to inability to feel pain or sense, or may be unaware of cuts or injuries.
Motor nerves are responsible for voluntary movement, muscle tone and coordination.
Due to the effects of chemotherapy, patients may experience problems with walking, lifting or other motor activities. Neurotoxicity may also involve cranial nerves outside of the CNS, however, discussion will concentrate of peripheral neuropathy involving sensory and motor nerves. Objective symptoms include reduction in deep tendon reflexes, usually appearing first in the legs, decreased vibratory sense, and reduced proprioception or decreased perception of location of the extremity in relation to space. As neuropathy increases in severity, patients may have a wide-gait stance or unsteady gait. Figure 1 .