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Research Objectives
To examine the contributions of persistent cancer-related fatigue (CRF) and chemotherapy-induced
peripheral neuropathy (CIPN) to pre- and post-exertional static and dynamic balance
among women with a history of breast cancer.
Design
Secondary analysis of cross-sectional data.
Setting
Outpatient private university laboratory
Participants
43 women who had completed chemotherapy for stage I-III breast cancer 3.5 ± 2.1 years
prior to study involvement were recruited from a breast cancer center in a large urban
hospital.
Interventions
Repeated sit-to-stands, representing a moderate-intensity lower extremity exercise,
were performed to volitional exhaustion or 15-minutes.
Main Outcome Measures
Postural sway was measured via force plate in the medial-lateral (ML) and anterior-posterior
(AP) planes in static standing and during the unsupported rising phase of an instrumented
sit-to-stand (ISTS) before and after exercise.
Results
CRF was a statistically significant predictor of static standing postural sway in
the AP plane before, p = 0.04, and after exercise, p = 0.02, with greater CRF predicting
greater AP sway. CRF accounted for greater variance in pre- and post-sway compared
to CIPN which was not a significant predictor. CRF was also a statistically significant
predictor of post-exertional rising phase sway in the AP plane, p = 0.01, with greater
CRF predicting smaller, more conservative anterior weight shifting during the ISTS.
CIPN was not a significant predictor of rising phase sway and accounted for less than
half of the variance as CRF.
Conclusions
CRF, even several years following exposure to chemotherapy, may distinctly influence
balance independent of CIPN symptoms. Individuals with CRF should be assessed for
instability regardless of CIPN status and should be educated regarding potential imbalance
following exercise or other fatiguing tasks. Clinicians should consider the order
of an objective examination of an individual with CRF, as postural stability may vary
based on whether it is tested before or after physically fatiguing tasks. CRF warrants
greater consideration in clinical practice and research as a mechanism of postural
instability.
Author(s) Disclosures
No conflicts of interest. This study was supported by a grant from the National Institute
on Aging.
Keywords
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© 2022 Published by Elsevier Inc.
