Does Neuromuscular Training Help Prevent Chemotherapy-Induced Neuropathy?

Chemotherapy-induced peripheral neuropathy (CIPN) is a common complication that negatively affects quality of life and may limit adherence to further cancer-directed therapy. Effective options for prevention are limited. In a multicenter, randomized trial conducted in Germany, investigators compared standardized twice-weekly neuromuscular exercise training versus standard care in adult patients receiving first-line chemotherapy. Randomization was stratified according to type of chemotherapy (oxaliplatin or vinca alkaloid) and age.

One hundred fifty-eight patients (mean age, 49; 59% male) were randomized to one of three groups: standard care alone or standard care plus a program of either sensorimotor or whole-body vibration training with a sports therapist. Patients were assessed for neuropathy before initiation of chemotherapy, at set points during and after treatment, and at usual oncology visits; patients with symptoms were referred to neurology.

Incidence of CIPN was significantly lower in the sensorimotor-training and whole-body vibration–training groups than in the control group (30.0% and 41.2%, respectively, vs. 70.6%; P=0.002). Benefit was greatest among patients in the sensorimotor-training group and those receiving vinca alkaloids. Among the outcomes improved with sensorimotor training compared with usual care only: balance control, vibration sensitivity, sense of touch, lower-leg strength, pain, burning sensation, need for chemotherapy dose reductions, and mortality.