# Optimising Exercise for Managing Chemotherapy-Induced Peripheral Neuropathy in People Diagnosed with Cancer

## TL;DR

This paper reviews how different types of exercise can help manage chemotherapy-induced nerve pain in cancer patients and offers guidance for healthcare providers.

## Contribution

The study synthesizes evidence on exercise interventions for CIPN and provides actionable recommendations for clinical practice.

## Key findings

- Multimodal exercise significantly improves CIPN symptoms, functionality, and quality of life.
- Eleven studies showed high methodological quality, with randomized trials scoring well on JBI tools.
- Exercise interventions like yoga, aerobic, and resistance training also showed benefits for CIPN management.

## Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) is a painful and disabling condition experienced by many individuals undergoing cancer treatment. Despite growing evidence that exercise can help reduce its symptoms and improve quality of life, clear and practical guidance for healthcare providers is lacking. This study explored various exercise methods to better understand their effects on CIPN and to identify effective strategies for integrating exercise into patient care. By synthesising current research and offering actionable recommendations, the authors aim to bridge the gap between scientific evidence and clinical practice, encouraging the use of exercise as a tool to alleviate the burden of CIPN. The findings could inspire further research and aid clinicians in improving care for individuals coping with this challenging side effect of chemotherapy.

Background: Chemotherapy-induced peripheral neuropathy is a common and debilitating side effect of cancer treatment. While exercise has shown promise in alleviating this burden, it remains underutilised in clinical practice due to the lack of accessible, clinician-friendly guidance. Aim: This review aimed to synthesise current evidence on exercise interventions for managing chemotherapy-induced peripheral neuropathy and provide practical insights to support clinicians in integrating these approaches into patient care. Methods: A search was conducted across MEDLINE, CINAHL, and SPORTDiscus using keywords related to exercise and CIPN. Studies were included if they involved adults receiving neurotoxic chemotherapy and exercise-based interventions. Two authors independently screened studies and resolved conflicts with a third author. Study quality was assessed using the JBI Critical Appraisal Tools, and only studies meeting a minimum quality standard were included. A balanced sampling approach was employed. Data on study design, participant characteristics, interventions, and outcomes were extracted. Results: Eleven studies were included, covering various exercise modalities: multimodal (n = 5), yoga (n = 2), aerobic (n = 1), resistance (n = 1), balance (n = 1), and sensorimotor (n = 1). Exercise interventions, particularly multimodal exercise, significantly improved symptom severity, functionality, and quality of life (p < 0.05). The studies had high methodological quality, with randomised controlled trials scoring between 9/13 and 11/13, and quasi-experimental studies scoring 8/9 on JBI tools. Conclusions: This review highlights the significant benefits of exercise, especially multimodal exercise, for managing CIPN and provides guidance for integrating these strategies into clinical practice. Future research is needed to refine exercise prescriptions and develop standardised guidelines.