Rehabilitation of balance disturbances due to chemotherapy-induced peripheral neuropathy: a pilot study.

Background: Cancer patients with chemotherapy-induced peripheral neuropathy (CIPN) have sensory and motor deficits leading to inappropriate proprioceptive feedback, impaired postural control, and fall risk. Balance training with computerized force platforms has been successfully used in rehabilitation of balance disturbances, but programs specifically developed for CIPN patients are lacking.

Aim: This pilot study evaluated a rehabilitation protocol exclusively based on visual computer-feedback balance training (VCFBT) to improve balance in patients with CIPN.

Design: Open-label, non-randomized pilot study, 4-week intervention with pre- vs. post-treatment evaluation.

Setting: Outpatients of the Rehabilitation Institute of the Salvatore Maugeri Foundation, in Genoa, Italy.

Population: Seven out-patients with clinical-instrumental diagnosis of CIPN.

Methods: At admission, patients were administered the Berg Balance Scale (BBS) and underwent static-dynamic posturography using a computerized force platform to objectively quantify their balance impairment. Their performance was compared to values of a normal age-matched population. Patients then underwent 4 weeks of VCFBT (three 60-minute sessions/week). At discharge, BBS and posturography were repeated and the results compared with those at admission.

Results: A significant pre- vs. post-treatment improvement was found in balance as measured by static-dynamic posturography (P=0.004) and BBS (P<0.002).

Conclusions: Despite caution needed for the low sample size, this pilot study has shown preliminary evidence that intensive rehabilitation, based on VCFBT can produce a significant improvement in balance outcomes.

Clinical Rehabilitation Impact: To our knowledge, this is the first report in CIPN patients of a rehabilitation program based exclusively on VCFBT.