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Submission To Be Reviewed

Title: A Home-Based Exercise Program To Improve Neuromuscular And Spatio-Temporal Gait Parameters In A Multiple Myeloma Cancer Survivor With Chemotherapy-Induced Peripheral Neuropathy: A Case Report”

Journal Section

Abstract:Introduction: Chemotherapy-induced peripheral neuropathy (CIPN) may cause functional impairments such as gait or balance disorders, that increase fall risk.  Gait disorders may be due to the neurotic effect of chemotherapy that causes a prolonged H-reflex latency and inability to inhibit spinal excitability (H-reflex), resulting in increased co-contraction of the lower extremity muscles.  

Purpose: To assess the efficacy of a home-based exercise program on lower extremity muscle co-contraction, spatio-temporal gait factors and fall risk in a multiple myeloma cancer patient undergoing chemotherapy and experiencing CIPN.

Methods: A case study was performed on a 67-year-old male diagnosed with multiple myeloma without achieving remission. The participant underwent stem cell transplantation and is currently undergoing chemotherapy treatment (bortezomib) 2x a week and has a history of falls secondary to CIPN.  The participant initiated home-based exercise program consisting of resistance, aerobic, balance, and stretching exercise 2-3x a week. The targeted home-based exercise program emphasizing closed kinetic chain strengthening exercises and anterior/posterior weight shifting balance exercises. Outcomes were assessed at baseline and 4 weeks after initiating the exercise program.

Results:  Considerable improvements were observed, such as increased step length and gait speed,  EMG data suggested improvements in activation timing and strength of the gastrocnemius and tibialis anterior through the gait cycle, as well as improvements in lower-extremity con-contractions observed at baseline. 

Conclusions: This was the first study to investigate the efficacy of a home-based exercise program on lower extremity muscle activation timing and gait characteristics of a cancer patient with CIPN that is currently receiving chemotherapy.  The present case study demonstrated that a home-based resistance exercise program may be a feasible intervention to help reduce co-contractions and improve the activation times and amplitudes of lower extremity muscles, which may help improve spatio-temporal gait parameters and reduce fall risk. 

Key Words: Exercise, Chemotherapy-Induced Peripheral Neuropathy, Gait, Fall, Co-contraction

Review Schedule

Editor's request 31-05-2018

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