Abstract
ABSTRACT
Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent complication of chemotherapy that affects the neurological system. Regular physical activity (PA), as well as enhancing exercise tolerance and motor function, may improve health-related quality of life (HRQoL) in cancer patients and survivors. Current research has indicated that regular physical activity is a cost-effective and safe intervention that can assist individuals with CIPN in addressing functional impairments and reducing the severity of established CIPN symptoms. However, it is worth noting that in South Africa there has been limited investigation into the impact of exercise interventions on motor performance and HRQoL. This is especially true for cancer patients and survivors who experience stable CIPN symptoms that significantly disrupt their daily functioning.
Objective: The aim of this study was to determine the relationship between self-reported exercise tolerance, motor performance and HRQoL in cancer patients and survivors with chemotherapy-induced peripheral neuropathy in Gauteng, South Africa.
Methods: A cross-sectional study was conducted. Self-reported questionnaires, namely the Global Physical Activity Questionnaire (GPAQ) and the Functional Assessment of Cancer Therapy-General/Neurotoxicity (FACT/GOG-NTX), were distributed throughout 14 oncology centres in Gauteng, South Africa and online (n=305). The data analysis employed the Statistical Package for Social Sciences (SPSS) and utilised both descriptive and inferential statistics for comprehensive analysis.
Results: This study included 305 participants in total. Of the 115 (46%) participants who were in remission, PA levels increased as the duration of remission increased, with 63.2% engaging in aerobic exercise for 0-12 months, 57.1% (1-2 years) and 81.6% (>2 years) of remission. Similarly, of the 135 (54%) participants undergoing chemotherapeutic treatment, PA levels showed that 36.7% participated in aerobic exercise for 0 to 8 months and 35.5% (>9 months) of treatment. Sixty-nine percent who met the American College of Sports Medicine (ACSM) PA guidelines experienced numbness and/or tingling in their hands or feet, 34.5% reported balance issues or trouble walking, and 55.2% reported loss of function or weakening in their hands. In contrast, physically inactive adults who did not fulfil the ACSM PA guidelines had greater incidence of these symptoms, with 69.3% feeling numbness and/or tingling, 42.6% reporting balance issues or trouble walking, and 42.6% reporting loss of function or weakening in their hands. Physical quality of life was shown to have relationships that were statistically significant with both social quality of life (p =.000) and functional quality of life (p =.000). A highly significant positive correlation was found between physical and emotional wellbeing (r = .608, p = .000). No significant relations were found between physical wellbeing and vigorous intensity exercise at work and for leisure. There was no major difference in HRQoL in the measured physical activity levels between the physically active participants (n=29) and physically inactive participants (n=101).
Conclusion: The findings point to the significant impact of CIPN on movement dysfunction, as well as the benefits of exercise therapy during treatment and in remission for improving HRQoL and reducing CIPN
IV
symptoms in both cancer patients and survivors alike. Public and private health initiatives should raise awareness about the benefits of regular physical activity, including aerobic exercises, for cancer patients and survivors with CIPN in South Africa.
Keywords: Chemotherapy-induced peripheral neuropathy, cancer, exercise, health-related quality of life.