Explicit Sensory Retraining in Physiotherapy to Treat People with Chemotherapy-Induced Peripheral Neuropathy (CIPN): A Feasibility Study

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a nerve damage condition caused by anti-neoplastic drugs, resulting in pain and sensory impairment in extremities, affecting balance and mobility. This study assessed the feasibility and effectiveness of a short sensory retraining physiotherapy treatment course for CIPN symptoms. Methods: A prospective feasibility trial (NCT05382520) was conducted in an outpatient cancer clinic. Twelve participants with chronic CIPN underwent three 45-minute sessions of explicit sensory retraining of the lower extremities. Primary outcome measures included the Visual Analogue Scale (VAS), Treatment Induced Neuropathy Assessment Scale (TNAS), and "Timed Up & Go" test (TUG). In addition, sensory function and balance as well as participant satisfaction were also evaluated. Statistical analysis used the Wilcoxon rank test with significance set at P <= 0.05. Results: All participants completed the intervention. Significant improvements were found in median "maximal pain intensity" (VAS-weekly max; P = 0.02) and median "average pain" (VAS-weekly average; P = 0.01). TUG median decreased significantly by 4.7 seconds (P = 0.01). TNAS scores decreased by 13.0 (P = 0.06). Several secondary outcome measures also showed significant improvements. Participant satisfaction was 82.4%. Conclusion: Explicit sensory retraining for lower extremities in individuals with CIPN is feasible and was found to be effective in both improving pain and mobility, with high participant satisfaction. This study suggests a new, mechanism-based therapeutic approach to ease CIPN symptoms, to be further investigated in prospective randomized trials.