Exercise as a non-pharmacological therapy for chemotherapy induced neuropathy: a systematic review

Abstract

Background and Objective: The most frequent neurological and clinically significant side effect of many frequently used chemotherapeutic drugs is chemotherapy-induced peripheral neuropathy (CIPN) which includes neuropathic pain. Peripheral neuropathy is commonly treated pharmacologically, which is frequently ineffective. Non-pharmacological therapies, particularly exercise, have been proven to be useful in preventing or attenuating CIPN. We conducted a systematic review to assess the effects of exercise on sensory complaints including hyperesthesic responses along with tingling and numbness, along with the quality of life (QoL) of CIPN patients. Databases and Data Treatment: The following string of Medical Subject Headings keywords was used to search the databases of PubMed, Web of Science, and Scopus for peer-reviewed articles: "(Pain OR Neuropathic pain) AND Exercise AND Chemotherapy-induced neuropathy". The relevant paper's reported outcome domains were all extracted. Results: From 349 identified literature records, 15 met the inclusion criteria. Exercise demonstrated positive effects on several CIPN symptoms including neuropathic pain and other common sensory symptoms and quality of life. Additionally, physical conditions that may indirectly affect pain, such as general fitness and balance, were improved. The general studies presented an overall high risk of bias. The heterogeneity of interventions and measurements did not allow a meta-analysis of the studies. Conclusions: It is feasible and effective to use various exercise routines for cancer patient's CIPN symptoms. Together with other typical sensory CIPN symptoms, neuropathic pain and patient's QoL improved. Further investigation is necessary to define protocols of exercise-based interventions to manage CIPN.