Novel Interventions for Chemotherapy-Induced Neuropathy

项目摘要：癌症治疗会导致剂量受限的感觉症状和姿势控制功能障碍 (神经病变)高达80%的乳腺癌(BC)幸存者，但仍未进行非侵入性治疗以恢复运动控制 仍然不发达。为了恢复灵活性，患者报告了针对运动控制的干预措施 症状和参与的动力--结合起来--最有可能成功。因此，我们建议测试 配对改编阿根廷探戈(Tango)作为同时修复靶点的理想干预方法的效果 通过以社会为动机的参与来提高机动性和缓解症状。探戈是中等强度的 社交舞，适合行动不便的人，提供感觉运动和心血管训练 有节奏的音乐。探戈通过创造性的参与和照顾者的包容来促进幸存者的参与。 研究人员之前的研究证实，探戈对于年老的幸存者(长达82岁)是可行的 对神经病相关的运动控制缺陷有很高的满意度和效果。因此，我们建议 进行一项第二阶段的随机临床试验，调查公元前52名患有神经病的幸存者的Tango。 我们的主要假设是，探戈与改善姿势控制(主要)以及 相对于以下证据，改善平衡、运动控制和患者报告的结果(PRO)(次要)- 基于家庭锻炼计划(HEX)。我们的理论基础：探戈结合了有节奏的听觉效果 姿势控制调节的刺激；神经运动控制和心血管的体力活动练习 健身；具有参与治疗的社会动力。我们的长期目标是优化预防和 利用非侵入性、以患者为中心的治疗改善运动控制的神经病的治疗 对于更多的人来说，肯定会更快。为了实现这一目标，不列颠哥伦比亚省的余额赤字幸存者 患有神经病的患者将被随机分配到探戈或HEX训练中，每周两次，为期8周。vbl.使用 作为一种意向治疗方法，这项创新的先导研究将确定探戈对(AIM1)姿势的影响 控制；2)平衡；3)优点，包括感觉症状、疼痛、疲劳、情绪、生活质量和内在 动机；以及探索(AIM2)运动控制。这些数据将使我们能够确定效果大小 并估计未来试验的样本量，该试验将调查神经运动控制和利弊之间的关系 参与运动控制和规划的大脑区域的结构变化，中枢多巴胺调节， 以及神经创伤患者的全身性炎症。

Project Abstract: Cancer treatment causes dose-limiting sensory symptoms and postural control dysfunction (neuropathy) in up to 80% of breast cancer (BC) survivors, yet non-invasive treatments to restore motor control remain underdeveloped. To restore mobility, interventions that address motor control, patient-reported symptoms, and motivation to participate - in combination - are most likely to succeed. Thus, we propose to test effect of partnered Adapted Argentine Tango (Tango) as an ideal intervention to simultaneously target restoration of mobility and alleviation of symptoms through socially-motivated participation. Tango is moderate intensity social dance, adapted for individuals with mobility deficits, that delivers sensorimotor and cardiovascular training to rhythmic music. Tango promotes survivor participation through creative engagement and caregiver inclusion. Previous research by the investigators established Tango as feasible for aging survivors (up to 82 years) to engage in with high satisfaction and effects to neuropathy-related motor control deficits. Therefore, we propose to conduct a Phase II, randomized clinical trial investigating Tango in 52 BC survivors with neuropathy. Our overarching hypothesis is that Tango is associated with improved postural control (primary) as well as improved balance, locomotor control and patient-reported outcomes (PROs) (secondary) relative to an evidence- based home exercise program (HEX). Our rationale: Tango combines the effects of rhythmic auditory stimulation on postural control regulation; physical activity practice on neuromotor control and cardiovascular fitness; with social motivation to participate in treatment. Our long-term goal is to optimize prevention and treatment of neuropathy utilizing non-invasive, patient-centered treatment to improve motor control more definitively and more quickly for more people. Toward this goal, BC survivors with balance deficits associated with neuropathy will be randomly assigned to Tango or HEX training, twice per week, for an 8 week period. Using an intent-to-treat approach, this innovative pilot study will determine impact of Tango on (AIM1) 1) postural control; 2) balance; 3) PROs including sensory symptoms, pain, fatigue, mood, quality of life, and intrinsic motivation; as well as explore (AIM2) 4) locomotor control. These data will enable us to establish effect sizes and estimate sample size for a future trial that will investigate relationship of neuromotor control and PROs to structural changes in regions of the brain involved in motor control and planning, central dopamine regulation, and systemic inflammation among individuals with neurotrauma.