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Can Physical Exercise Prevent Chemotherapy-Induced Peripheral Neuropathy in Patients With Cancer? A Systematic Review and Meta-analysis

  • Maria Lopez-Garzon
    Affiliations
    Cuídate' from Biomedical Group (BIO277), University of Granada, Granada, Spain

    Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain

    Instituto de Investigación Biosanitaria ibs, Granada, Spain
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  • Irene Cantarero-Villanueva
    Affiliations
    Cuídate' from Biomedical Group (BIO277), University of Granada, Granada, Spain

    Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain

    Instituto de Investigación Biosanitaria ibs, Granada, Spain

    Sport and Health Joint University Institute (iMUDS), University of Granada, Granada, Spain

    Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
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  • Paula Postigo-Martin
    Affiliations
    Cuídate' from Biomedical Group (BIO277), University of Granada, Granada, Spain

    Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain

    Instituto de Investigación Biosanitaria ibs, Granada, Spain

    Sport and Health Joint University Institute (iMUDS), University of Granada, Granada, Spain
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  • Ángela González-Santos
    Correspondence
    Corresponding author Ángela González Santos, MSc, Avda de la Ilustración 60, 18016 Granada, Spain.
    Affiliations
    Cuídate' from Biomedical Group (BIO277), University of Granada, Granada, Spain

    Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain

    Instituto de Investigación Biosanitaria ibs, Granada, Spain
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  • Mario Lozano-Lozano
    Affiliations
    Cuídate' from Biomedical Group (BIO277), University of Granada, Granada, Spain

    Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain

    Instituto de Investigación Biosanitaria ibs, Granada, Spain

    Sport and Health Joint University Institute (iMUDS), University of Granada, Granada, Spain

    Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
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  • Noelia Galiano-Castillo
    Affiliations
    Cuídate' from Biomedical Group (BIO277), University of Granada, Granada, Spain

    Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain

    Instituto de Investigación Biosanitaria ibs, Granada, Spain

    Sport and Health Joint University Institute (iMUDS), University of Granada, Granada, Spain

    Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
    Search for articles by this author
Published:March 07, 2022DOI:https://doi.org/10.1016/j.apmr.2022.02.008

      Abstract

      Objective

      This systematic review analyzed the effects of physical exercise programs in patients with cancer undergoing chemotherapy on chemotherapy-induced peripheral neuropathy (CIPN) prevention.

      Data Sources

      PubMed, Web of Science, Scopus, and Cochrane Library were searched for relevant studies published before December 2020. Additional references were identified by manual screening of the reference lists.

      Study Selection

      Based on the Population, Intervention, Comparator, Outcomes, and Study Designs strategy, randomized controlled trials in which physical exercise was applied before or during chemotherapy to prevent or ameliorate CIPN were included.

      Data Extraction

      Two reviewers blinded and independent screened the articles, scored methodologic quality, and extracted data for analysis. The review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Sensitivity and precision analysis databases was included. Risk of bias assessment and meta-analysis were conducted using the Cochrane tools.

      Data Synthesis

      Of 229 potentially relevant studies, 8 randomized controlled trials were included and scored. They comprise a total of 618 patients with cancer. MEDLINE and Scopus databases recorded the highest sensitivity. None of the studies achieved a “low” overall risk of bias. Four studies were included in meta-analysis for quality of life, and a significance standardized mean difference was found between groups from baseline of 14.62; 95% CI, 6.03-3.20, with a large effect size g=0.83; 95% CI, 0.48-1.18) in favor of physical exercise program compared with usual care.

      Conclusions

      Physical exercise at the onset of chemotherapy has shown promising effects on the prevention of CIPN, specially improving quality of life.

      Keywords

      List of abbreviations:

      CG (control group), CIPN (chemotherapy-induced peripheral neuropathy), FITT (frequency, intensity, time and type), IG (intervention group), RCT (randomized controlled trial), TOI (Trial Outcome Index)
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