The effects of exercise on chemotherapy-induced peripheral neuropathy symptoms in cancer patients: a systematic review and meta-analysis

Support Care Cancer. 2021 Sep;29(9):5303-5311. doi: 10.1007/s00520-021-06082-3. Epub 2021 Mar 4.


Purpose: To conduct a systematic review and meta-analysis of current studies to determine whether exercise affects chemotherapy-induced peripheral neuropathy (CIPN) symptoms in cancer patients.

Design: The Medline, Embase, Cochrane Library, CINAHL, PubMed, and National Central Library databases, and the reference lists of the included studies were surveyed. The Consolidated Standards of Reporting Trials (CONSORT) extension checklist for non-pharmacologic treatment was used to evaluate the literature.

Setting and participants: Exercise interventions offered in hospitals or at home. A total of 178 participants from 5 studies were assessed in the meta-analysis, with their mean age ranging from 48.56 to 71.82 years.

Methods: The randomized control trials were summarized in a systematic review. The effects of the exercise interventions were compiled for meta-analysis. A forest plot was constructed using a fixed effect model to obtain a pooled mean difference.

Results: The pooled results indicated that exercise interventions significantly improved the CIPN symptoms of the participants (mean difference: 0.5319; 95% confidence interval: 0.2295 to 0.8344; Z = 3.45; P = 0.0006). A combination of exercise protocols including a nerve gliding exercise intervention was found to have improved CIPN symptoms. In addition, a sensorimotor-based exercise intervention was found to have reduced CIPN-induced loss of postural stability.

Conclusions and implications: The findings indicated that the effects of exercise could improve CIPN symptoms in cancer patients. Nevertheless, further investigations of different exercise protocols and intensity of intervention utilizing larger sample sizes and more specific outcome measures will further inform the best practices for cancer patients.

Keywords: Cancer; Chemotherapy-induced peripheral neuropathy; Exercise; Meta-analysis; Systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Aged
  • Antineoplastic Agents / adverse effects
  • Exercise*
  • Humans
  • Middle Aged
  • Neoplasms* / drug therapy
  • Peripheral Nervous System Diseases* / chemically induced
  • Peripheral Nervous System Diseases* / therapy


  • Antineoplastic Agents