Falls, functioning, and disability among women with persistent symptoms of chemotherapy-induced peripheral neuropathy

Kerri Winters-Stone, Fay Horak, Peter Jacobs, Phoebe Trubowitz, Nathan Dieckmann, Sydnee Stoyles, Sara Faithfull

Research output: Contribution to journalArticle

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Abstract

Purpose Chemotherapy-induced peripheral neuropathy (CIPN) may persist after treatment ends and may lead to functional decline and falls. This study compared objective and self-report measures of physical function, gait patterns, and falls between women cancer survivors with and without symptoms of CIPN to identify targets for functional rehabilitation. Methods A secondary data analysis of 512 women cancer survivors (age, 62 6 6 years; time since diagnosis, 5.8 6 4.1 years) categorized and compared women self-reporting symptoms of CIPN (CIPN+) with asymptomatic women (CIPN2) on the following: maximal leg strength, timed chair stand, physical function battery, gait characteristics (speed; step number, rate, and length; base of support), self-report physical function and disability, and falls in the past year. Results After an average of 6 years after treatment, 47% of women still reported symptoms of CIPN. CIPN+ had significantly worse self-report and objectively measured function than did CIPN2, with the exception of maximal leg strength and base of support during a usual walk. Gait was slower among CIPN+, with those women taking significantly more, but slower and shorter, steps than did CIPN2 (all P, .05). CIPN+ reported significantly more disability and 1.8 times the risk of falls compared with CIPN2 (P, .0001). Increasing symptom severity was linearly associated with worsening function, increasing disability, and higher fall risk (all P, .05). Conclusion This work makes a significant contribution toward understanding the functional impact of CIPN symptoms on cancer survivors. Remarkably, 47% of women in our sample had CIPN symptoms many years after treatment, together with worse function, greater disability, and more falls. CIPN must be assessed earlier in the clinical pathway, and strategies to limit symptom progression and to improve function must be included in clinical and survivorship care plans.

Original languageEnglish (US)
Pages (from-to)2604-2612
Number of pages9
JournalJournal of Clinical Oncology
Volume35
Issue number23
DOIs
StatePublished - Aug 10 2017

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Peripheral Nervous System Diseases
Drug Therapy
Self Report
Survivors
Gait
Leg
Neoplasms
Critical Pathways
Therapeutics
Rehabilitation
Survival Rate

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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Falls, functioning, and disability among women with persistent symptoms of chemotherapy-induced peripheral neuropathy. / Winters-Stone, Kerri; Horak, Fay; Jacobs, Peter; Trubowitz, Phoebe; Dieckmann, Nathan; Stoyles, Sydnee; Faithfull, Sara.

In: Journal of Clinical Oncology, Vol. 35, No. 23, 10.08.2017, p. 2604-2612.

Research output: Contribution to journalArticle

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abstract = "Purpose Chemotherapy-induced peripheral neuropathy (CIPN) may persist after treatment ends and may lead to functional decline and falls. This study compared objective and self-report measures of physical function, gait patterns, and falls between women cancer survivors with and without symptoms of CIPN to identify targets for functional rehabilitation. Methods A secondary data analysis of 512 women cancer survivors (age, 62 6 6 years; time since diagnosis, 5.8 6 4.1 years) categorized and compared women self-reporting symptoms of CIPN (CIPN+) with asymptomatic women (CIPN2) on the following: maximal leg strength, timed chair stand, physical function battery, gait characteristics (speed; step number, rate, and length; base of support), self-report physical function and disability, and falls in the past year. Results After an average of 6 years after treatment, 47{\%} of women still reported symptoms of CIPN. CIPN+ had significantly worse self-report and objectively measured function than did CIPN2, with the exception of maximal leg strength and base of support during a usual walk. Gait was slower among CIPN+, with those women taking significantly more, but slower and shorter, steps than did CIPN2 (all P, .05). CIPN+ reported significantly more disability and 1.8 times the risk of falls compared with CIPN2 (P, .0001). Increasing symptom severity was linearly associated with worsening function, increasing disability, and higher fall risk (all P, .05). Conclusion This work makes a significant contribution toward understanding the functional impact of CIPN symptoms on cancer survivors. Remarkably, 47{\%} of women in our sample had CIPN symptoms many years after treatment, together with worse function, greater disability, and more falls. CIPN must be assessed earlier in the clinical pathway, and strategies to limit symptom progression and to improve function must be included in clinical and survivorship care plans.",
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T1 - Falls, functioning, and disability among women with persistent symptoms of chemotherapy-induced peripheral neuropathy

AU - Winters-Stone, Kerri

AU - Horak, Fay

AU - Jacobs, Peter

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AU - Dieckmann, Nathan

AU - Stoyles, Sydnee

AU - Faithfull, Sara

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N2 - Purpose Chemotherapy-induced peripheral neuropathy (CIPN) may persist after treatment ends and may lead to functional decline and falls. This study compared objective and self-report measures of physical function, gait patterns, and falls between women cancer survivors with and without symptoms of CIPN to identify targets for functional rehabilitation. Methods A secondary data analysis of 512 women cancer survivors (age, 62 6 6 years; time since diagnosis, 5.8 6 4.1 years) categorized and compared women self-reporting symptoms of CIPN (CIPN+) with asymptomatic women (CIPN2) on the following: maximal leg strength, timed chair stand, physical function battery, gait characteristics (speed; step number, rate, and length; base of support), self-report physical function and disability, and falls in the past year. Results After an average of 6 years after treatment, 47% of women still reported symptoms of CIPN. CIPN+ had significantly worse self-report and objectively measured function than did CIPN2, with the exception of maximal leg strength and base of support during a usual walk. Gait was slower among CIPN+, with those women taking significantly more, but slower and shorter, steps than did CIPN2 (all P, .05). CIPN+ reported significantly more disability and 1.8 times the risk of falls compared with CIPN2 (P, .0001). Increasing symptom severity was linearly associated with worsening function, increasing disability, and higher fall risk (all P, .05). Conclusion This work makes a significant contribution toward understanding the functional impact of CIPN symptoms on cancer survivors. Remarkably, 47% of women in our sample had CIPN symptoms many years after treatment, together with worse function, greater disability, and more falls. CIPN must be assessed earlier in the clinical pathway, and strategies to limit symptom progression and to improve function must be included in clinical and survivorship care plans.

AB - Purpose Chemotherapy-induced peripheral neuropathy (CIPN) may persist after treatment ends and may lead to functional decline and falls. This study compared objective and self-report measures of physical function, gait patterns, and falls between women cancer survivors with and without symptoms of CIPN to identify targets for functional rehabilitation. Methods A secondary data analysis of 512 women cancer survivors (age, 62 6 6 years; time since diagnosis, 5.8 6 4.1 years) categorized and compared women self-reporting symptoms of CIPN (CIPN+) with asymptomatic women (CIPN2) on the following: maximal leg strength, timed chair stand, physical function battery, gait characteristics (speed; step number, rate, and length; base of support), self-report physical function and disability, and falls in the past year. Results After an average of 6 years after treatment, 47% of women still reported symptoms of CIPN. CIPN+ had significantly worse self-report and objectively measured function than did CIPN2, with the exception of maximal leg strength and base of support during a usual walk. Gait was slower among CIPN+, with those women taking significantly more, but slower and shorter, steps than did CIPN2 (all P, .05). CIPN+ reported significantly more disability and 1.8 times the risk of falls compared with CIPN2 (P, .0001). Increasing symptom severity was linearly associated with worsening function, increasing disability, and higher fall risk (all P, .05). Conclusion This work makes a significant contribution toward understanding the functional impact of CIPN symptoms on cancer survivors. Remarkably, 47% of women in our sample had CIPN symptoms many years after treatment, together with worse function, greater disability, and more falls. CIPN must be assessed earlier in the clinical pathway, and strategies to limit symptom progression and to improve function must be included in clinical and survivorship care plans.

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