Rehabilitation, exercise, and related non-pharmacological interventions for chemotherapy-induced peripheral neurotoxicity: Systematic review and evidence-based recommendations

Pharmacological strategies for chemotherapy-induced peripheral neurotoxicity (CIPN) are very limited.We systematically reviewed data on rehabilitation, exercise, physical therapy, and other physical non-pharmacological interventions and offered evidence-based recommendations for the prevention and treatment of CIPN.A literature search using PubMed, Web of Science and CINAHL was conducted from database inception until May 31st, 2021.2791 records were title-abstract screened, 71 papers were full-text screened, 41 studies were included, 21 on prevention and 20 on treatment of CIPN. Treatment type, cancer type, chemotherapy compounds were heterogeneous, sample size was small (median: N = 34) and intention-to-treat analysis was lacking in 26/41 reports.Because of the methodological issues of included studies, the reviewed evidence should be considered as preliminary. Exercise, endurance, strength, balance, and sensorimotor training have been studied in low-to-moderate quality studies, while the evidence for other treatments is preliminary/inconclusive. We offer recommendation for the design of future trials on CIPN.

Automated summary

Pharmacological strategies for chemotherapy-induced peripheral neurotoxicity (CIPN) are limited. This study systematically reviewed non-pharmacological interventions for CIPN and provided evidence-based recommendations. However, due to methodological issues in the included studies, the reviewed evidence should be considered as preliminary.