Exercise Effect on Chemotherapy-Induced Neuropathic Pain, Peripheral Nerve Fibers

University Of Maryland Baltimore, Baltimore MD

Investigators

Abstract

PROJECT SUMMARY     There are over 14 million cancer survivors in the United States, many of whom suffer from chemotherapy- induced peripheral neuropathy (CIPN) as a late effect of neurotoxic chemotherapy. CIPN presents as bilateral numbness and tingling in the hands and feet and typically progresses to include neuropathic pain. CIPN- related neuropathic pain (CIPN-NP) develops during chemotherapy and often persists for 6 months and beyond following treatment completion. As such, CIPN-NP results in long-term suffering, disability, and decreased quality of life for cancer survivors. There are no agents available to prevent the development of CIPN, and treatment of symptoms with anti-epileptics, anti-depressants, and opioids is suboptimal at best. Exercise, a non-pharmacologic intervention, holds promise as a new modality for reducing CIPN-associated pain and functional decline. Thus far aerobic exercise and resistive training have been shown to 1) reduce severity of CIPN development in patients being treated for hematologic cancer; and 2) improve nerve fiber integrity in patients with diabetes. In this study, we will examine the effect of aerobic exercise and resistive training on CIPN-NP in subjects who have completed chemotherapy treatment for 6 months or longer. The purpose of this study, therefore, is to test our hypothesis that exercise will decrease pain and improve nerve fiber integrity in subjects with persistent CIPN-NP following chemotherapy completion. We will test our hypothesis with the following study aims:   AIM1: Determine the effects of aerobic exercise and resistive training versus attention control on CIPN- NP (quantitative sensory testing, Neuropathic Pain Scale) in cancer survivors who have completed chemotherapy. AIM 2: Determine the effects of aerobic exercise and resistive training versus attention control on peripheral sensory fiber and epidermal innervation integrity in subjects with CIPN-NP.