Complex neural pathways

Chemotherapy-Induced Peripheral Neuropathy and Physiotherapy

Scientific article in Fysioterapeuten 4/2013

Abstract

Gro S. Haugen, Spesialfysioterapeut og spesialist i onkologisk fysioterapi MNFF. Seksjon for kreftrehabilitering, Radiumhospitalet. Kreft, -kirurgi og transplantasjonsklinikken, Oslo Universitetssykehus, gsu@ous-hf.no 

Inger-Lise Nesvold, Spesialfysioterapeut og forsker, PhD. Seksjon for kreftrehabilitering, Radiumhospitalet. Kreft, -kirurgi og transplantasjonsklinikken, Oslo Universitetssykehus. 

Åse Sagen, Spesialfysioterapeut og forsker, PhD. Avdeling for Kreftbehandling, Kreftsenteret, Ullevål, Oslo Universitetssykehus.

Abstract

Introduction:The trend with continuing increase in cancer incidence, more advanced treatment and higher survival rates results in an increasing number of survivors with possibly long-term adverse effects from the cancer treatment. Chemotherapy-induced peripheral neuropathy (CIPN) represents one of many adverse effects related to cancer treatment. So far guidelines for testing and treatment are almost absent. Thus, there is a demand for competence among physiotherapists concerning tests and treatment within this area. The aim of this article is to give an account of present knowledge of CIPN and to present relevant methods of assessment.

Main section:Neurotoxic chemotherapy, which is used in treatment of cancer, is mainly vinca-alkaloids, taxanes and cisplatin. The adverse effects of the treatment may give CIPN, mainly limited to sensory functions with paresthesias as numbness, pain or other disturbed sensibilities in the peripheral part of the limbs. Furthermore, motor functions can also be impaired and can affect the postural control (balance) and thereby an increased risk of fall. A questionnaire and different physical tests measuring strength, balance and physical function are presented.

Conclusion:Systematic surveys to identify CIPP symptoms, including both self-report and clinical tests are important aspects of physiotherapy for these patients. There is a demand for research in this area, including tools for both testing and treatment of CIPN.

Key words:Chemotherapy-induced peripheral neuropathy, self-reported symptoms and functional testing, physiotherapy.

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