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Abstract
BackgroundThe increase in newly diagnosed patients with cancer in South Africa and globally, may contribute to the increase in patients living with chemotherapy-induced peripheral neuropathy (CIPN). Chemotherapy-induced peripheral neuropathy negatively impacts on quality of life (QoL) during and post chemotherapy treatment. Physiotherapy management of CIPN helps patients to manage symptoms and improves function in activity- and participation-levels to ultimately improve QoL. However, little evidence exists regarding the type or combination of physiotherapy management strategies in South Africa.ObjectivesThe purpose of our study was to determine how the symptoms of CIPN were managed by physiotherapists in Pretoria, South Africa.MethodA quantitative, descriptive study design was used. Electronic questionnaires were distributed to physiotherapists who worked with cancer patients and who treated patients with CIPN.ResultsPhysiotherapists used massage, proprioceptive neuromuscular facilitation, sensory integration, activities of daily living training, postural drainage, lifestyle modifications; Bobath-, breathing-, stability-, stretching-, strengthening- and endurance-exercises; electrical stimulation, thermal modalities, transcutaneous electrical nerve stimulation, soft tissue mobilisation; muscle energy-, positional- and Mulligan-techniques in the management of CIPN.ConclusionCardiopulmonary therapy, therapeutic exercises, manual therapy and neuro-developmental techniques were used by physiotherapists in the management of CIPN. Almost half of the participants did not use electrotherapy techniques. Physiotherapy management strategies that are used in Pretoria are similar to published research.Clinical implicationsPhysiotherapists in Pretoria are managing CIPN according to international practices. However, studies to determine the effectiveness of the management strategies in a South African context should be conducted. Alternative management strategies, based on the pathophysiology of CIPN, should be explored.Keywordsphysiotherapy; chemotherapy-induced peripheral neuropathy; intervention; management; cancer.
Highlights
Worldwide it is projected that the incidence of cancer diagnoses will increase by 50% in the 10 years (National Cancer Institute 2017)
Despite the increased number of patients surviving cancer and the acknowledgement that physiotherapy plays a role in the management of these patients, the small sample size in our study may be interpreted as being that very few physiotherapists in Pretoria solely treat the side effects with which oncology patients present
All the physiotherapists who participated in our study indicated that they use therapeutic exercises for the management of chemotherapy-induced peripheral neuropathy (CIPN) which is similar to international standards and current best practices
Summary
Worldwide it is projected that the incidence of cancer diagnoses will increase by 50% in the 10 years (National Cancer Institute 2017). The National Cancer Institute (2017) projected that more than 60% of these diagnoses will affect Africa, South- and Central America and Asia. Chemotherapy is one of the most common methods of treating cancer (Zajczkowska et al 2019) This method of treatment benefits patients enormously, chemotherapy is well known for its considerable side effects. Worldwide chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common side effects of chemotherapy and can affect up to 68% of people receiving chemotherapy (Molassiotis et al 2019). The increase in newly diagnosed patients with cancer in South Africa and globally, may contribute to the increase in patients living with chemotherapy-induced peripheral neuropathy (CIPN). Little evidence exists regarding the type or combination of physiotherapy management strategies in South Africa
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