Kinematic evaluation for impairment of skilled hand function in chemotherapy-induced peripheral neuropathy

Introduction: Chemotherapy-induced peripheral neuropathy (CIPN) usually affects both sensory and motor function of hands and feet, resulting in impaired skilled hand function (e.g., typing a keyboard). However, quantitative and objective evaluations for this condition have not been established. Purpose of the Study: We evaluated skilled hand function using a kinematic analysis and investigated relationships among hand kinematic function and the clinical sensory and motor features of CIPN. Study Designs: Clinical measurement. Methods: Twelve CIPN patients and 12 age-matched control participants were enrolled. We recorded their reach and grasp movements using a three-dimensional measurement system, and calculated the normalized jerk of these movements as quantitative indexes of skilled hand function. Additionally, we used the number of sequential hand grip release cycles in 10 seconds as an evaluation of clinical motor function. Results: Our kinematic analyses revealed significant difference in normalized jerk of grasp movement (CIPN: 3.7 +/- 0.2, control: 3.4 +/- 0.1; P = .005), but this was not the case for reach movement (CIPN: 2.5 0.1, control: 2.5 +/- 0.2; P = .43), indicating that the distal part of the forearm is particularly affected in CIPN. Such disturbed grasp movement was directly correlated with poor scores on the hand grip release test and the sensory tests. Discussion: We revealed deficit impaired hand function objectively and quantitatively in CIPN patients using a kinematic analysis. Further, the hand grip test could represent such kinematic abnormality and could be useful for evaluating skilled hand function of CIPN patients. Conclusions: Our kinematic and clinical measurements objectively and quantitatively evaluate skilled hand function in individuals with CIPN in clinical settings. (C) 2017 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.