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Evaluation of the effects of sensorimotor exercise on physical and psychological parameters in breast cancer patients undergoing neurotoxic chemotherapy

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SPRINGER
DOI: 10.1007/s00432-018-2686-5

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Breast cancer; Mamma-carcinoma; Chemotherapy; Paclitaxel; Taxol; Neurotoxic; Neuropathy; Chemotherapy-induced peripheral polyneuropathy; Nerves; Sensorimotor exercise; Training; Exercise intervention; Posturometry; Posturography; Sway area; Monopedal stance; Bipedal stance; Fullterton Advanced Balance Scale; FAB; Postural instability; Risk of falling; Fall risk; Strength; Upper extremity; Lower extremity; Hand dynamometer; Chair rising test; Eortc; European organization of research and treatment of cancer; Qol; Quality of life; QLQ-C30; CIPN-20; BR-23; Multidimensional Fatigue Inventory; MFI-20; Adverse events; Survivors

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Introduction Breast cancer is the most common cancer disease of women in industrialized countries. Neurotoxic chemotherapy drugs are known to harm peripheral nerves and cause a chemotherapy-induced peripheral neuropathy (CIPN). CIPN is one of the most common adverse events associated with Paclitaxel chemotherapy and may remain present long after the termination of chemotherapy. Thus, it reduces the patients' quality of life (QoL) both during chemotherapy and onwards, and can impose a danger on breast cancer survivors due to an increased risk of falling and fall-related injuries. Methods The aim of this randomized-controlled trial (RCT) (n = 36) (IG: intervention group, n= 17) (CG: control group, n= 19) was to determine whether sensorimotor exercises have a positive effect on physical and psychological parameters in breast cancer patients undergoing neurotoxic chemotherapy (Paclitaxel). Results As a result, we were able to show significant improvements in postural stability in monopedal stance [left leg 16.17 +3.67 vs. 21.55 +5.33 (p < 0.001) and right leg 15.14 +2.30 vs. 20.85 +5.05 (p < 0.001)] and in bipedal stance [T1 vs. TO, - 0.49 (IG) vs. +1.14 (CG)p = 0.039]. Discussion These results in posturography correlate with the clinical presentation with intervention group patients scoring significantly better on the Fullerton Advanced Balance Scale [37.71 +2.73 vs. 34.47 +3.98 (p = 0.004)]. Moderate strength training successfully prevented a strength loss in the IG that was remarkable in the CG (-1.60 vs. 0.60, p = 0.029). Concerning the psychological parameters assessed via EORTC- and MFI-questionnaires, no significant improvements were found. Conclusion Future studies should focus on the correlation of clinical and posturometry findings and subjective QOL such as the long-term-development of CIPN.

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