Nancy Campbell, MS, an exercise physiologist with Dana-Farber's Adult Survivorship Program, provides some tips and exercises that can help manage the symptoms of neuropathy. This presentation was originally given on March 27, 2013 through Dana-Farber's Blum Resource Center.
2. Agenda
What is chemotherapy induced peripheral neuropathy
(CIPN)?
How exercise may help with symptoms
Practice exercises
3. What is Chemotherapy Induced Peripheral
Neuropathy (CIPN)?
A group of neuromuscular symptoms that result from
nerve damage caused by drug therapies used during
cancer treatment
Affects 30-90% of patients getting specific neurotoxic
chemotherapy drugs
The most commonly used classes of drugs causing
CIPN are taxanes (Taxol and Taxotere) and platinum
based drugs (Cisplatin and Oxaliplatin)
http://www.slideshare.net/DanaFarber/chemorelated-neuropathy-managing-this-nerve-wracking-problem
4. Symptoms
Vary from person to person based on type of treatment
and individual differences
Numbness, tingling and discomfort in the upper or
lower extremities are the hallmark of CIPN
Can last for months to years after chemotherapy and
sometimes is permanent
It can interfere with the ability to perform usual
activities
http://www.slideshare.net/DanaFarber/chemorelated-neuropathy-managing-this-nerve-wracking-problem
5. Benefits of Exercise
People with neuropathy have reduced:
Proprioception
Sensation in lower extremities
Ankle strength
This can lead to increased risk for falls
Strength and balance training leads to fewer falls
6. How Exercise May Help
Toftagen, C et al. Strength and Balance Training for Adults with Peripheral Neuropathy and High Risk of Fall. Onc Nurs For. 39, 5,
2012.
7. Tips for Foot Neuropathy
If you have numbness in your feet you should:
Wear comfortable, properly fitting shoes
Avoid sandals, open toed or heeled shoes
Inspect feet daily for injury
Avoid walking barefoot or in socks alone
Always check for foreign objects in shoes before
putting them on
Change shoes in the middle of the day
Consider making an appointment for physical or
occupational therapy
8. Tips for Hand Neuropathy
If you have numbness in your fingers you should:
Wear warm clothing in cold weather and protect
hands from extreme cold
Use care when washing dishes or taking a bath or
shower and do not let the water get too hot
Use potholders when cooking
Use gloves when washing dishes, gardening
Inspect skin for cuts, abrasions and burns
Consider making an appointment for physical or
occupational therapy
10. Finger Rolls
Extend arms in front of you at shoulder height with
palms facing away from you
Starting with your little finger, curl your hand into a
fist one finger at a time
Rotate the fist to face you
Then open up your fingers one at a time, again starting
with your little finger
Then rotate our palm back to the front
Repeat with your left hand
Do 4 sets of finger rolls
Thriving After Breast Cancer. Sherry Lebed Davis and https://www.youtube.com/watch?v=KK1Uf56mNC8
11. Finger Roll with Fist
Extend your arms in front of you at shoulder height
with palms facing ceiling
Starting with your little finger, curl your hand into a
fist one finger at a time and make a fist
Squeeze the fist, then open up fingers, squeeze again
Do 4 sets of finger rolls
https://www.youtube.com/watch?v=KK1Uf56mNC8
12. Finger Taps
Extend your arms in front of you at shoulder height
with palms facing ceiling
Touch your little finger to your thumb, then ring
finger, then middle finger, then index
Then unwind starting with index finger straightening,
then middle finger, then ring
Do 4 sets of finger taps
https://www.youtube.com/watch?v=KK1Uf56mNC8
13. Finger Taps
Place the palms of your hands in your lap
Lift the index finger twice and tap your lap
Repeat twice with each finger is succession
Do 4 sets of finger taps
14. Ankle Circles
Sit on the edge of a chair
with knees bent at 90
degrees
Extend right leg straight
Perform 10 clockwise
ankle circles
Perform 10 counter-
clockwise ankle circles
Repeat with left leg
http://thephysicaltherapysourceankle.blogspot.com/2007/01/ankle-ankle-circles.html
15. Standing Heel to Toe
Beginner: Stand and hold on to a chair for support.
Place right foot directly in front of left foot, eyes open,
arms at side or across chest
Look straight ahead at stationary object
Hold for up to 30 seconds
Repeat with left foot in front
Intermediate: Stand without holding on to chair
Advanced: Repeat with eyes closed
16. Standing Side Leg
Stand next to a chair in an upright
position, with feet together
Maintain your balance by gently
touching the back of a chair with
your right hand.
Raise your left leg in an outward
motion, as far as possible. Make
sure the left foot continues to point
forward.
Hold for 2 seconds and return slowly
to the starting position.
Make sure to keep your back straight
as you raise your left leg. Your head,
spine, and stationary leg should be
aligned.
Keep your abdominal muscles
engaged throughout the movement.
Repeat with the other leg.
http://www.health24.com/fitness/Exercises/16-1339-1346,20052.asp
17. Calf Raise
Stand with your feet hip
distance apart, with a slight
bend in your knees
While maintaining total body
alignment, raise heels off the
floor
Lower slowly and repeat
Lift for 3 counts, hold for 1-2
counts, lower for 4 counts
Perform 2 sets of 10 reps
Progression:
Perform calf raise off a step
for more range of motion
http://truly-healthy.blogspot.com/2010/10/6-simple-strength-training-exercises.html
18. Calf Stretch
Place hands on wall at
shoulder height
Extend one leg behind you
in a lunging position
Make sure all 10 toes are
facing forward, toward the
wall in front of you
Bend your front knee, but
make sure knees don’t
extend over your toes
Stop movement when
slight tension is felt and
hold for 20-30 seconds
http://www.furnacebrookpt.com/how_physical_therapy_can_help_you/ptcanhelpyou_plantar_fasciitis.html
19. Resources
Dana-Farber Adult Survivorship Program
Exercise consultation
www.dana-farber.org/exercise or 617-632-4523
Women’s Strength Class
Tuesday 10-11, Friday 1:30-2:30
Dana-Farber Zakim Center
Acupuncture, massage, qi gong, yoga
www.dana-farber.org/zakim or 617-632-3399
http://www.dana-farber.org/research/clinical-trials/clinical-
trial.aspx?tid=4207
Dana-Farber exercise research studies
http://www.dana-farber.org/Research/Clinical-
Trials/Clinical-Trials-Search-Result.aspx?q=exercise