The detrimental association between fear of falling and motor performance in older cancer patients with chemotherapy-induced peripheral neuropathy.
The detrimental association between fear of falling and motor performance in older cancer patients with chemotherapy-induced peripheral neuropathy.
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DOI：
10.1016/j.gaitpost.2021.05.022
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发表时间：
2021-07
期刊：
影响因子：
2.4
通讯作者：
Najafi B
中科院分区：
文献类型：
--
作者：
Kang GE;Murphy TK;Kunik ME;Badr HJ;Workeneh BT;Yellapragada SV;Sada YH;Najafi B
患有化疗诱导的周围神经病变（CIPN）的癌症患者的福尔斯风险增加，并出现跌倒恐惧（FoF）。虽然FoF可能会继续损害运动性能，并增加进一步下降的风险，这种关联仍然在CIPN中未被探索。CIPN患者的高FoF是否会进一步恶化CIPN相关感觉缺陷造成的运动功能障碍？在对从两项临床试验中收集的数据进行的二次分析中，习惯性步行条件下的步态参数和30秒安静站立期间的姿势摇摆参数（睁眼和闭眼）在老年参与者中进行了比较（≥ 65岁）CIPN和高FoF（CIPN FoF+; n = 16），CIPN和低FoF（CIPN FoF-; n = 19）的老年参与者和正常老年对照（即，非癌症、非糖尿病、非神经病学和非整形外科; n = 16）。我们使用可穿戴传感器（BioSensics，Newton，MA，USA）测量步态和姿势摇摆参数，并使用国际福尔斯疗效量表测量FoF严重程度。组间差异最大的是步态速度。CIPN FoF+组的步态速度（0.78 ± 0.21 m/s）显著低于CIPN FoF−组（0.93 ± 0.17 m/s）和正常对照组（1.17 ± 0.13 m/s）（所有p <0.05;效应量分别为0.79和2.23）。我们发现，在所有CIPN参与者中，步态速度和FoF严重程度之间存在显著相关性（R2 = 0.356; p <0.001）。在CIPN参与者中，CIPN FoF+和CIPN FoF−组之间的姿势摇摆参数没有显著差异。我们的研究结果表明，步态表现进一步恶化的患者与CIPN和高FoF超出CIPN相关的感觉缺陷的损害。我们的研究结果还表明，需要进一步研究FoF和跌倒风险，因为FoF是医疗保健提供者可以在临床实践中使用的简单工具。
Cancer patients with chemotherapy-induced peripheral neuropathy (CIPN) are at increased risk of falls and developing fear of falling (FoF). Although FoF may continue to impair motor performance and increase the risk of falling even further, this association remains unexplored in CIPN. Does high FoF in patients with CIPN further deteriorate motor performance beyond the impairment from CIPN-related sensory deficits? In this secondary analysis of data collected from two clinical trials, gait parameters during habitual walking condition and postural sway parameters during 30-second quiet standing (eye-open and eyes-closed) were compared among older participants (≥ 65 years) with CIPN and high FoF (CIPN FoF+; n = 16), older participants with CIPN and low FoF (CIPN FoF−; n = 19) and normal older controls (i.e., non-cancer, non-diabetic, non-neurologic, and non-orthopedic; n = 16). We measured gait and postural sway parameters using wearable sensors (BioSensics, Newton, MA, USA), and FoF severity using the Falls Efficacy Scale-International. The largest between-group differences were found in gait speed. The CIPN FoF+ group had significantly slower gait speed (0.78 ± 0.21 m/s) than the CIPN FoF− (0.93 ± 0.17 m/s) and normal control groups (1.17 ± 0.13 m/s) (all p < .05; effect sizes = 0.79 and 2.23, respectively). We found a significant association between gait speed and FoF severity (R2 = 0.356; p < .001) across all participants with CIPN. Among participants with CIPN, no significant differences in postural sway parameters were found between the CIPN FoF+ and CIPN FoF− groups. Our results suggest that gait performance further deteriorates in patients with CIPN and high FoF beyond the impairment from CIPN-related sensory deficits. Our results also suggest further research is needed regarding FoF, and fall risk, as FoF is a simple tool that healthcare providers can use in clinical practice.
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