Efficacy of combined hand exercise intervention in patients with chemotherapy-induced peripheral neuropathy: a pilot randomized controlled trial
Efficacy of combined hand exercise intervention in patients with chemotherapy-induced peripheral neuropathy: a pilot randomized controlled trial
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DOI：
10.1007/s00520-022-06846-5
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发表时间：
2022-02-21
影响因子：
3.1
通讯作者：
Higashi, Toshio
中科院分区：
文献类型：
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作者：
Ikio, Yuta;Sagari, Akira;Higashi, Toshio
目的以往关于运动干预对化疗引起的周围神经病变影响的证据通常集中在下肢功能，如肌肉力量和平衡能力，而其对上肢的影响尚不清楚。我们的目的是评估联合手部运动干预对化疗引起的周围神经病变（CIPN）患者上肢功能、症状和生活质量的疗效。方法筛选出341例患者，其中42例随机分为干预组和对照组，每组21例。参与者在基线（T0）和一个（T1）和两个（T2）化疗周期后进行评估。主要结局是T2时使用密歇根手部结局问卷（MHQ）测量的上肢功能。使用混合效应模型比较意向治疗人群和实际治疗人群。结果在意向治疗分析中，干预组与对照组相比，T2时MHQ患者日常生活活动能力的下降明显受到抑制（差异：7.23，95%可信区间：0.35-14.10）。同样，在治疗分析中，与对照组相比，干预组在T2时MHQ日常生活活动能力的下降受到显著抑制（差异：13.09; 95%置信区间：5.68-20.49）。与对照组相比，T2时干预组的疼痛也显著改善（差异：13.21; 95%置信区间：-22.91至-3.51）。结论手部运动综合干预可改善CIPN患者的上肢功能，如抑制ADL的下降，减轻疼痛。
Purpose Previous evidence regarding the impact of exercise interventions on chemotherapy-induced peripheral neuropathy often focuses on lower-extremity functions, such as muscle strength and balance ability, while their effects on upper extremities remain unknown. We aimed to evaluate the efficacy of combined hand exercise intervention on upper-extremity function, symptoms, and quality-of-life in patients with chemotherapy-induced peripheral neuropathy (CIPN). Methods After screening 341 patients, 42 were randomly assigned to either the intervention (n = 21) or control (n = 21) group. Participants were evaluated at baseline (T0) and after one (T1) and two (T2) chemotherapy cycles. The primary outcome was upper-extremity function measured using the Michigan Hand Outcomes Questionnaire (MHQ) at T2. The intention-to-treat and as-treated populations were compared using a mixed-effect model. Results In the intention-to-treat analysis, the decline in activities of daily living of MHQ was significantly suppressed in the intervention group compared with that in the control group at T2 (difference: 7.23; 95% confidence interval: 0.35-14.10). Similarly, in the as-treated analysis, the decline in activities of daily living of MHQ was significantly suppressed in the intervention group compared with that in the control group at T2 (difference: 13.09; 95% confidence interval: 5.68-20.49). Pain also significantly improved in the intervention group compared with that in the control group at T2 (difference: 13.21; 95% confidence interval: - 22.91 to - 3.51). Conclusion The combined hand exercise intervention may improve upper-extremity function, such as by suppressing decline in ADL, and reduce pain in patients with CIPN.