Table Info

Table 1.

Summary of the most relevant studies about CIPN and PA

Reference	Number subjects, age, median (range), sex, IG–CG	Diagnosis	Methods	Protocol	Outcome measurement	Results	Conclusions
Kneis et al. [11]	Pre-protocol subjects: N = 37 IG: 18, female: 14, male: 4, age median 70 (44–82) CG: 19, female: 12, male: 7, age median 60 (46–75)	Breast cancer, colorectal cancer, gynecological cancer, upper gastrointestinal cancer, NSCLC, non-Hodgkin’s lymphoma, multiple myeloma	One-on-one IG: 12 weeks twice/weekly (endurance + balance training) CG: active control group (endurance training)	Endurance training: 30 min stable bike moderate intensity (under the IAT) Balance training: 3–8 exercises 3 repetitions each 20/30 s progressively increasing exercise difficulty (reducing the support surface, visual input, adding motor/cognitive tasks, and instability induction	Functional performance CIPN symptoms and QoL Cardiorespiratory fitness	Endurance training induced a reduction in sensory symptoms in both groups, while balance training additionally improved patients’ functional status	Both exercises provide a clear and relevant benefit for patients with CIPN
Streckman et al. [12]	N = 61 IG: 30 CG: 31	Lymphoma	IG: 36 weeks, 2 times per week (sensorimotor-, endurance- and strength training) CG: usual care	Endurance training: Treadmill, bike-dynamometer 70–80% HRmax Sensorimotor: 4 postural stabilization tasks progressively increase task difficulty Resistance training: 4 exercises carried out at maximum force	QoL (EORTC QLQ-C30 questionnaire) Movement coordination, endurance, strength, and therapy-induced side-effects	Increase of balance in IG compared with CG. Static (P = 0.03), dynamic (P = 0.007), perturbed (P = 0.009), and bipedal (P = 0.006)	Exercise, especially sensorimotor training provide benefit to cancer patients, ↑ QoL (emotional function, pain, constipation, diarrhea), ↓ side-effects, ↑ balance control, ↑ mobility
Kleckner et al.[13]	N = 355, age: 56 ± 11, 93% female IG: 170 CG: 185	Different types of cancer (mostly breast cancer)	IG: 6 weeks, daily session (EXCAP^©®) CG: usual care	Endurance training: Low-to-moderate walking: 60–85% of HRR Strength training: Bands: RPE of 3–5 (1–10 scale)	Effects of exercise on CIPN symptoms Factors that predict CIPN symptoms Factors that moderate effects of exercise on CIPN symptoms	Reduction symptoms (on 10-point scale) hot/cold in hand/feet (-0.46 point) P = 0.045; reduction numbness and tingling (-0.42 point) P = 0.061 More effect in older people (P = 0.086), male (P = 0.028), and breast cancer (0.076)	Exercise appears to reduce CIPN symptoms in patients receiving taxane-, platinum-, or vinca alkaloid-based chemotherapy
Vollmers et al. [14]	N = 36 IG: 17, age: 48.56 ± 11.94 CG: 19, age: 52.39 ± 10.14	Breast cancer	IG: 2 times/week during chemotherapy and 6 weeks after the end (physical training and sensorimotor exercises) CG: received an instruction sheet with a PA program to do autonomously by the patients	Not reported	Balance, upper and lower strength, QoL (EORTC and MFI questionnaires)	No significant difference reported	↑ Postural stability in IG Moderate strength exercises proved to prevent a loss of upper extremity strength ↑ In the decreased intensity of CIPN or possibly faster remission
Zimmer et al. [15]	N = 30 IG: 17 CG: 13	Colorectal cancer	IG: 8 weeks–two times/week (a combo of endurance and resistance training) CG: usual care (written standard recommendations to obtain physical fitness)	Endurance training: Walking, bicycle ergometer, or cross-trainer Resistance training: Circuit training of bench press, lat pulldown, leg press, seated row, and abdominal exercise	Trial outcome index (TOI) Balance	Neuropathic symptoms remained stable in the IG over time, while CIPN significantly worsened in CG of 7.14 points (P = 0.077) of the FACT/GOG-NTX questionnaire IG significantly Improved strength and balance function	↓ CIPN symptoms, ↑ balance, ↑ strength, ↑ QoL
Henke et al. [16]	N = 29 IG: 18 CG: 11	Lung cancer (NSCLC and SCLC)	IG: 5 times/week endurance training and breathing technique; 2 times/week strength training CG: usual care	Endurance training: Walking 55–70% of HRR Strength training: 50% of RM	Barthel index QoL (EORTC QLQ C-30/LC-13 questionnaire)	Barthel index was significantly worse after the intervention in CG (P = 0.041); functional capacity increased more in IG (6MWT); an increased single score of EORTC QLQ C-30/LC-13 questionnaire	↑ QoL (physical functioning, hemoptysis, pain in arms or shoulder, peripheral neuropathy, cognitive functioning) Training has a positive effect on the patient’s endurance and strength capacity
Wonders et al. [17]	N = 6 (finished the intervention), female subjects	Breast cancer	IG: 10-week home-based program CG: not present	Endurance training: Moderate-intensity 55–65% of their self-estimated HRR Increase gradually from 20 min (1st week) to 150 min (10th week) of exercise per week Resistance training: Not reported	CIPN symptoms rate QoL (McGill QoL questionnaire)	Significantly lowered levels of both troublesome and pain symptoms	↓ CIPN symptoms ↑ QoL (level of troublesome symptoms related to peripheral neuropathy) Low adherence rate Difficulty getting subjects to complete the 10-week program
Andersen Hammond et al. [18]	N = 48 IG: 22 mean age 56.3 ± 9.9 CG: 26 mean age 53.0 ± 10.3	Breast cancer	IG: 3 times daily home-based exercise program; 5/10 min every session CG: usual care	Nerve gliding exercise program	Effects of exercise on CIPN symptoms QoL (DASH questionnaire) Strength	Less pain for IG (P = 0.053) preservation of vibration (P = 0.001) and heat pain thresholds (left P = 0.021, right P = 0.039) Significant improvements in grip strength	↓ CIPN pain ↓ Pain pressure ↑ Grip dynamometry
Van Waart et al. [19]	N = 230 IG: 153; HBI = 77, HIP = 76 CG: 77	Breast or colon cancer	IG: divided into “Onco-Move program” and “OnTrack program” CG: usual care	Onco-Move: Home-based program, 30 min, 5 days/week, 12–14 Borg Scale, exercises not reported OnTrack program: Supervised 20 min, 2 days/week Endurance training: 30 minutes, 50% to 80% of the maximal workload, exercises not reported Resistance training: 2 series of 8 repetitions at 80% of the 1RM	Cardiorespiratory fitness, upper muscle strength, lower muscle strength, fatigue, QoL (EORTC QLQ-C30 questionnaire), functioning in daily life, quality of sleep, return to work, psychological distress, self-reported PA level, chemotherapy regimen, dose, and adverse effects of chemotherapy, compliance with exercise programs	IGs: less decline of cardiorespiratory fitness (P < 0.001), better physical functioning (P < 0.001), less pain (HBI P = 0.003, HIP P = 0.011)	Both IGs provide a benefit for patients, especially the HIP group
McCrary et al. [20]	A single group for pre and post N = 29 mean age 61.6 (32–79) Female 21, male 8	Breast cancer, colorectal cancer, ovarian cancer, endometrial cancer, appendix cancer, lymphoma, myeloma, urothelial, carcinoma	IG: 8 weeks, 3 times weekly (resistance training, balance training, and endurance training) CG: not present	Exercises performed at RPE of 13–15 (6–20 scale)	Objective CIPN, patient-reported CIPN, patient-reported disability, QoL (SF-36 questionnaire), mobility, dynamic balance/leg strength, standing balance, sensoryneurophysiology, motor neurophysiology	Dynamic balance, standing balance in eye-open conditions, mobility, and QoL were improved (P ≤ 0.05) Ameliorating objective CIPN and patient reported CIPN	Significance increasing of: Objective CIPN, patient-reported CIPN, patient-reported disability, QoL, mobility Dynamic balance, stable surfacewith eyes open, unstable surface with eyes open

IG: intervention group; CG: control group; HRmax: maximum heart rate; HRR: heart rate reserve; RM: maximum repetitions; RPE: rated perceived exertion; IAT: individual anaerobic threshold; 1RM: one repetition maximum; NSCLC: non-small cell lung cancer; SCLC: small-cell lung cancer; ↑: increase; ↓: decrease; 6MWT: 6-minute walking test; HBI: home-based intervention; HIP: high intensity program

Declarations

Author contributions

DD designed the study and wrote the first draft of the manuscript; ES and CC contributed to the study conception and design; L Marinelli, LP, L Mori and CT revised the manuscript. All authors read and approved the submitted version.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

Not applicable.

Consent to participate

Not applicable.

Consent to publication

Not applicable.

Availability of data and materials

Not applicable.

Funding

Not applicable.

Copyright

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