Low-Intensity Vibration to Reduce Symptoms and Improve Physical Functioning in Cancer Survivors With Chemotherapy-Induced Peripheral Neuropathy: A Pilot Randomized Trial

低强度振动疗法可减轻化疗引起的周围神经病变癌症幸存者的症状并改善其身体机能:一项初步随机试验

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Abstract

PURPOSE: Chemotherapy-induced peripheral neuropathy (CIPN) can have deleterious effects on mobility and quality of life in people with cancer. Vibration therapy shows promise as a CIPN intervention but is understudied. We investigated the feasibility and preliminary efficacy of low-intensity vibration (LIV) in cancer survivors with CIPN. METHODS: We conducted a pilot randomized controlled trial in adult cancer survivors with persistent CIPN symptoms. Participants were randomly assigned to twice-daily LIV sessions (10 min/session; 30 Hz, 0.4 g) for 12 weeks or usual care (UC). We assessed feasibility by accrual, retention, adherence, and adverse event (AE) reporting. We evaluated preliminary efficacy by changes in patient-reported CIPN symptoms (Functional Assessment of Cancer Therapy/Gynecologic Oncology Group Neurotoxicity), pain (Brief Pain Inventory), fatigue (Patient-Reported Outcome Measurement Information System Fatigue), and physical functioning (Late-Life Function and Disability Instrument) and objectively measured physical functioning (chair stand time, gait speed), stability (postural sway), and mobility (Timed-Up-and-Go). Linear regression models were used to generate effect size estimates (Cohen's d). RESULTS: We accrued 95% of our target sample (n = 38, mean age: 62.6 ± 9.9 years, 89% female, median time since chemotherapy completion: 18 [6-39] months), with 20 participants randomly assigned to LIV and 18 to UC. Trial retention was 97% and mean adherence to LIV was 77% ± 18%. There were no serious AEs. Compared with UC, LIV participants reported greater improvements in sensory neuropathy symptoms (LIV, +1.4 ± 3.3 points; UC, +0.2 ± 2.8 points; Cohen's d = 0.45) and basic lower extremity function (LIV, +5.3 ± 8.5 points; UC, -0.7 ± 9.2 points; Cohen's d = 0.80), with moderate-to-large effect sizes for changes in stability, mobility, and gait (Cohen's d = 0.60-0.66). CONCLUSION: LIV is safe, feasible, and shows preliminary efficacy for CIPN symptom relief and improving physical functioning in cancer survivors with CIPN.

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