Exercise-based rehabilitation for cancer survivors with chemotherapy-induced peripheral neuropathy

Support Care Cancer. 2019 Oct;27(10):3849-3857. doi: 10.1007/s00520-019-04680-w. Epub 2019 Feb 12.


Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) affects up to 40% of cancer survivors and is associated with functional deficits and an increased falls incidence. There are presently no strongly recommended treatment strategies for CIPN. The aim of this study was to evaluate the impact of a multimodal exercise intervention on CIPN symptoms and related functional deficits, as well as neurophysiologic parameters.

Methods: All outcomes were assessed before and after an 8-week exercise intervention (3-weekly sessions) and preceding 8-week control period at baseline, pre-exercise and post-exercise. Outcome measures were objective and patient-reported CIPN, standing and dynamic balance, mobility, quality of life, and sensory and motor nerve excitability and conduction studies.

Results: Twenty-nine cancer survivors (8 male, 21 female; mean age 61.6 ± 11.8 years) with CIPN symptoms affecting function completed all assessments. Objective and patient-reported CIPN, dynamic balance, standing balance in eyes open conditions, mobility and quality of life were improved from pre- to post-exercise (4.0 < F < 10.2; p < .05), with no changes over the control period (p > .21). No changes were observed in sensory or motor neurophysiologic parameters (p > .23).

Conclusions: This study provides encouraging evidence of the rehabilitative potential of multimodal exercise for persisting CIPN in a post-treatment cohort. Large randomised controlled trials are justified to confirm observed benefits and determine the mechanisms and clinical significance.

Keywords: Aerobic training; Balance training; Neurophysiology; Resistance training; Survivorship.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Cancer Survivors*
  • Cohort Studies
  • Exercise / physiology
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / drug therapy
  • Outcome Assessment, Health Care
  • Oxaliplatin / adverse effects
  • Oxaliplatin / therapeutic use
  • Paclitaxel / adverse effects
  • Paclitaxel / therapeutic use
  • Peripheral Nervous System Diseases / chemically induced*
  • Peripheral Nervous System Diseases / therapy*
  • Quality of Life


  • Antineoplastic Agents
  • Oxaliplatin
  • Paclitaxel