Zusammenfassung

BACKGROUND: Cancer patients with chemotherapy-induced peripheral neuropathy (CIPN) have deficits in sensory and motor skills leading to inappropriate proprioceptive feedback, impaired postural control and high fall risk. OBJECTIVE: This proof-of-concept study investigated the acceptability and effect of an interactive motor adaptation balance training program based on wearable sensors for improving balance in older cancer patients with CIPN. METHODS: Twenty-two patients (age 70.3±8.7 years) with objectively confirmed CIPN (Vibration perception threshold, VPT > 25 Volts) were randomized to either intervention (IG) or control (CG) group. The IG received interactive game-based balance training including repetitive weight shifting and virtual obstacle crossing tasks. Wearable sensors provided real-time visual/auditory feedback from lower limb trajectory and allowed perception of motor-errors during each motor-action. The CG received no intervention, while recommended to perform regular exercise at home. Outcome measures were changes in sway of ankle, hip, and center of mass (CoM) in both medio-lateral (ML) and anterior-posterior (AP) directions during 30-second balance tests with increasing task difficulty (i.e. standing in feet-closed-position with eyes open (EO) and eyes closed (EC), and in semi-tandem-position with EO), at baseline and post-intervention. Additionally, gait performance (speed, variability) and fear of falling (Falls-Efficacy-Scale-International, FES-I) were measured. RESULTS: Training was safe and well accepted despite participants’ impaired health status, high severity of CIPN (VPT=49.6±26.7 Volts) and high fear of falling (FES-I=35.10±13.78). Post intervention, sway of hip, ankle, and CoM were significantly reduced in the IG compared to CG during standing in feet-close-position with EO (p=.010–.022, except AP CoM sway) and semi-tandem-position (p=.008–.035, except ankle sway). While improvement trends were observed for balance with EC (8–39%), gait speed (8%), and FES-I (7%) in IG, they did ...