The impact of walking exercise guided by the theory of unpleasant symptoms on peripheral neuropathy and arthralgia-myalgia in breast cancer patients undergoing paclitaxel treatment: A randomized controlled trial

Abstract

Purpose: This study aimed to evaluate the effectiveness of walking exercise, guided by the Theory of Unpleasant Symptoms (TOUS), in alleviating peripheral neuropathy and arthralgia-myalgia in women with breast cancer receiving paclitaxel.

Methods: This two-group repeated-measures randomized study was conducted in the outpatient unit of a medical oncology clinic in Türkiye between July 2022 and July 2023. A total of 82 women with breast cancer were enrolled and randomly assigned to either the intervention group (n = 41) or the control group (n = 41) using block randomization. Participants in the intervention group received education on the benefits of physical activity according to the TOUS framework and were provided with pedometers. Motivational interviews were conducted at the start, at 4 weeks, and at 8 weeks, with walking activity monitored throughout the study. Data were collected using a demographic information form, the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool (CIPNAT), and the McGill Pain Questionnaire-Short Form (MPQ-SF).

Results: After 12 weeks, the intervention group showed a significant reduction in both peripheral neuropathy and arthralgia-myalgia pain compared to the control group. The analysis indicated that both the group effect and the group × time interaction were significantly improved (p < 0.001).

Conclusions: Walking exercise, when integrated with the Theory of Unpleasant Symptoms, effectively reduces peripheral neuropathy and arthralgia-myalgia in women undergoing paclitaxel treatment for breast cancer. The findings are important in terms of encouraging a holistic approach to patient care by strengthening nursing interventions.

Keywords: Arthralgia-myalgia; Exercise; Nursing theory; Paclitaxel; Peripheral neuropathy.