Supportive care: Comparing exercise interventions for upper extremity polyneuropathy induced by chemo- or immunotherapy - VISCIPH B.

The VISCIPH B pilot study demonstrated high feasibility with strong adherence and retention rates for supervised exercise interventions in cancer patients with upper-extremity polyneuropathy.

• Adherence rate was 86% across both intervention groups
• Retention rate was 69% across both intervention groups
• 42 of 61 randomized patients completed the intervention (mean age 53.3 years, 36% male)
• No intervention-related adverse events were reported
• Both interventions were supervised twice weekly over 12 weeks in a single-center randomized controlled pilot trial (DRKS00023287)

Combined sensorimotor plus vibration exercise (PNPEX) produced significantly more responders than moderate resistance exercise (MREX) in upper-extremity polyneuropathy symptoms.

• 50% of PNPEX participants (10/20) were classified as responders compared to 14% (3/21) in MREX
• Odds ratio for response was OR = 5.45, p = 0.043
• 61 cancer patients with symptomatic upper-extremity PNP were randomized 1:1 to either intervention
• Responder classification was based on exploratory effect analyses of symptom response

FACT/GOG-Ntx neuropathy symptom scores improved significantly in the PNPEX group but not in the MREX group, with a significant difference between groups.

• FACT/GOG-Ntx scores improved significantly in PNPEX (p = 0.017)
• FACT/GOG-Ntx scores did not improve significantly in MREX (p = 0.46)
• The difference in FACT/GOG-Ntx improvement between the two groups was statistically significant (p = 0.05)

The PNPEX group showed significant improvements in numbness and tingling, depth sensitivity, and global health status.

• Significant improvements in numbness and tingling as measured by NRS (p = 0.001) in the PNPEX group
• Depth sensitivity improved at four of the eight tested bone sites in the PNPEX group
• Global health status (EORTC QLQ-C30) improved significantly in the PNPEX group (p = 0.001)
• Depth sensitivity was assessed using the Rydel-Seiffer tuning fork

Chemotherapy and immunotherapy-induced peripheral neuropathy is a prevalent and persistent condition affecting a substantial proportion of cancer patients, with limited evidence for upper-extremity interventions.

• Chemotherapy and immunotherapy-induced peripheral neuropathy affects up to 68% of cancer patients
• Symptoms may persist long after treatment, substantially impairing daily functioning and quality of life
• While exercise therapy has demonstrated benefits in lower-limb polyneuropathy, evidence for upper-extremity symptoms was described as scarce prior to this study