Gait and Balance Changes in Chemotherapy Induced Peripheral Neuropathy

描述(由申请人提供)：化疗引起的周围神经病变(CIPN)是几种常用化疗药物的剂量限制性毒性。在许多不同的人群中，包括老年人、糖尿病患者和癌症患者，周围神经病变已被证明会导致疼痛、跌倒、行走困难和进行日常生活活动。基于之前来自其他组周围神经病变患者的数据，我们研究的中心假设是CIPN导致步态和平衡改变，类似于在老年和糖尿病周围神经病变人群中观察到的情况。 为了验证我们的假设，我们将首先描述乳腺癌和结直肠癌患者在接受紫杉醇和奥沙利铂药物化疗期间步态和平衡的变化。具体地说，我们将评估(1)时空步态参数，包括节奏、步长和步宽，以及(2)平衡参数，包括接触时间和95%椭圆形面积，以每个患者作为自己的对照。随后，我们将比较步态和平衡参数变化的自然历史与CIPN状态的变化，这些变化由经过验证的客观和患者报告工具测量，包括CIPN研究中常用的TNS、EORTC CIPN-20和BPI。 我们研究的长期目标是减轻CIPN对癌症患者行动能力和生活质量的负担。这项应用的总体目标是量化由于奥沙利铂和紫杉醇化疗而发生的功能缺陷的自然病史。这项研究的完成将确立评估平衡和步态参数作为CIPN预测因子的可行性。如果成功，这将是一个易于实施的CIPN客观评估，用于未来评估有助于缓解甚至预防乳腺癌和结直肠癌幸存者CIPN的干预措施的有效性。

DESCRIPTION (provided by applicant): Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting toxicity1 of several commonly used classes of chemotherapy drugs. Peripheral neuropathies have been shown to lead to pain, falls, difficulty in walking and performing activities of daily living in many different populations including the elderly, diabetics, and, caner patients. Based on previous data from other groups of patients with peripheral neuropathies, the central hypothesis of our study is that CIPN results in altered gait and balance, similar to what has been observed in elderly and diabetic populations with peripheral neuropathy. To test our hypothesis, we will first characterize the alterations in gait and balance that occur i breast and colorectal cancer patients during chemotherapy with paclitaxel and oxaliplatin agents. Specifically, we will evaluate (1) spatiotemporal gait parameters, including cadence, step length, and step width, and (2) balance parameters, including time-to-contact and 95% ellipse area, using each patient as his/her own control. Subsequently, we will compare the natural history of changes in gait and balance parameters with changes in CIPN status as measured by validated objective and patient-report instruments including the TNS, EORTC CIPN-20 and BPI that are in commonly used in CIPN research. The long-term goal of our research is to reduce the burden of CIPN on cancer patients' mobility and quality of life. The overall objective of this application is to quantify the natural history o functional deficits that occur due to chemotherapy with oxaliplatin and paclitaxel. Completion of this study will establish the feasibility of evaluating balance and gait parameters as predictors o CIPN. If successful, then this will be an easy to implement and objective assessment of CIPN for future assessment of effectiveness of interventions that help mitigate or perhaps even prevent CIPN in breast and colorectal cancer survivors.