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A Novel Approach of Intraneural Facilitation Versus Standard Physical Therapy for the Prevention of Chemotherapy-Induced Peripheral Neuropathy: A Randomized Controlled Trial.

Researchers

Jamie Hankins, Mark Bussell, Lida Gharibvand, Won Jin Jeon, Dani Ran Castillo, Ellen D'Errico, Gayathri Nagaraj

Abstract

This study compared Intraneural Facilitation (INF<sup>&#xae;</sup>) therapy and standard physical therapy (PT) in preventing chemotherapy-induced peripheral neuropathy (CIPN) in women with newly diagnosed breast and gynecologic cancer. Thirty-eight women undergoing platinum and/or taxane-based chemotherapy, without prior peripheral neuropathy, were randomized into INF<sup>&#xae;</sup> therapy (n&#x2009;=&#x2009;20) and PT (n&#x2009;=&#x2009;18). Treatments lasted 45&#x2009;minutes, twice weekly, for 6&#x2009;weeks. Neuropathy severity was evaluated using the Pain Quality Assessment Scale. Assessments were at baseline, 3&#x2009;weeks, 6&#x2009;weeks, and 3&#x2009;months post-intervention. Acceptability, burden, and satisfaction were evaluated after 6&#x2009;weeks. Among 38 patients, 12 (32%) experienced CIPN, with mean pain scores remaining mild (&#x2264;3) and no pharmacotherapy required until week 6. No adverse events were reported from the interventions. The INF<sup>&#xae;</sup> therapy arm showed significant changes in numbness (<i>F</i>&#x2009;=&#x2009;6.030, <i>P</i>&#x2009;=&#x2009;.001, partial &#x3b7;<sup>2</sup>&#x2009;=&#x2009;0.262) after week 6, while the PT arm showed significant changes in numbness (<i>Z</i>&#x2009;=&#x2009;-2.39, <i>P</i>&#x2009;=&#x2009;.017), tingling (<i>Z</i>&#x2009;=&#x2009;-2.84, <i>P</i>&#x2009;=&#x2009;.004), cramping (<i>Z</i>&#x2009;=&#x2009;-2.120, <i>P</i>&#x2009;=&#x2009;.034), surface pain (<i>Z</i>&#x2009;=&#x2009;-2.75, <i>P</i>&#x2009;=&#x2009;.006), and deep pain (<i>Z</i>&#x2009;=&#x2009;-1.99, <i>P</i>&#x2009;=&#x2009;.046) between weeks 3 and 6. Nearly 80% of patients completed chemotherapy cycles with an average relative dose intensity of 90.4% (INF<sup>&#xae;</sup> therapy: 87.73% vs PT: 73.44%). Ninety-four percent of patients were satisfied with their care, accepted the treatments, and perceived them as a low burden. The results demonstrated that INF<sup>&#xae;</sup> therapy and PT are feasible options for CIPN, improving treatment adherence, outcomes, and quality of life for women with newly diagnosed breast and gynecological cancers.<b>Trial Registration</b> - The study was pre-registered on ClinicalTrials.gov (NCT03272919). August 8, 2017.
Source: PubMed (PMID: 41840756)View Original on PubMed