Wearable sensor-based balance training in older adult cancer patients with chemotherapy-induced neuropathy: A randomized controlled trial.

Abstract

195 Background: Chemotherapy-induced peripheral neuropathy (CIPN) can affect lower extremity joint proprioception leading to balance deficits and increased fall risk. This study evaluated the effect of a sensor-based exercise program on improving postural control in cancer patients with CIPN. Methods: Twenty two cancer patients (Age 70.3±8.7 years) with objectively confirmed CIPN (vibration perception threshold test, VPT > 25 Volt) were randomized to twice weekly x 4 weeks sensor-based training including weight shifting and virtual obstacle crossing with real-time visual feedback of lower-extremities through wearable wireless sensors (intervention group, IG, n = 11) or no intervention (control group, CG, n = 11). Outcome measures included changes in sway of ankle, hip, and center of mass (CoM) in both medio-lateral (ML) and anterior-posterior (AP) directions during 30 second standing in feet closed position (both feet next to each other) with eyes open (EO) and eyes closed (EC), and semi-tandem position (big toe by arch of other foot) with EO, at baseline and post-intervention. All assessments were made using validated wearable sensors. Results: VPT score averaged 49.6 ± 26.7 Post intervention, sway of hip, ankle and CoM (ML) were significantly reduced in the IG compared to the CG during FC position (p = .010-.022). During the more challenging position of semi-tandem, all sway parameters except ankle were significantly reduced (p = .008-.039). Effect sizes were moderate-large (eta squared = .255-.388). Conclusions: This randomized controlled study using a novel wireless sensor-based training demonstrated improvements in balance in CIPN patients by measures of balance that have been related to fall risk. We speculate that the sensor-based training with real-time visual joint position feedback provided participants with enhanced information about joint movements and motor error in order to compensate for deteriorated/lost lower extremity joint proprioception from CIPN. This balance training system can be easily translated to an in-home setting and may decrease fall risk and thus improve cancer patients’ quality of life. Clinical trial information: NCT02043834.