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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 neurotoxic effect of chemotherapy that causes a prolonged H-re ex latency and inability to inhibit spinal excitability (H-re ex), resulting in increased co-contraction of the lower extremity muscles. Purpose
To assess the ef cacy 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 initially received 5 months of Velcade (bortezomib) which is when they began experiencing CIPN symptoms. The participant then underwent an autologous stem cell transplantation and is currently receiving darzalex, which the participant states exacerbates symptoms of CIPN. The participant has a history of falls secondary to CIPN. The participant initiated a home-based exercise program consisting of resistance, aerobic, balance, and stretching exercises two to three times per week. Outcomes were assessed at baseline and 4 weeks after initiating the exercise program.
Results
The participant demonstrated increased step length and velocity during gait. EMG data suggested improvements in activation timing and strength of the gastrocnemius and tibialis anterior throughout the gait cycle, as well as improvements in lower-extremity co-contractions. Conclusion
This was the rst study to investigate the ef cacy 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 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.