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E.A. Niemand1, M.E. Cochrane1, C.A. Eksteen1
1Sefako Makgatho Health Sciences University, Department of Physiotherapy, Pretoria, South Africa

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common side effects of certain chemotherapy drugs. It can have a debilitating effect on the patient with cancer’s quality of life (QoL), both during and post chemotherapy treatment. The increase in newly diagnosed patients with cancer in South Africa and globally may contribute to the increase in patients living with CIPN. Chemotherapy-induced peripheral neuropathy may impact the patient on a sensory, motor and/or autonomic level. Physiotherapy management of CIPN assists patients to manage symptoms and improve function on an activity- and a participation level to ultimately improve their QoL. However, in South Africa, little evidence exists regarding the type or combination of physiotherapy management strategies for CIPN.  

Purpose: The purpose of this study was to determine how the symptoms related to CIPN were managed by physiotherapists in Pretoria, South Africa.

Methods: A quantitative, descriptive study design was used. Qualified physiotherapists in Pretoria, South Africa who treated patients diagnosed with cancer and/or treated patients with CIPN, were identified.  The participants received a link to an electronic questionnaire (derived from the Physical Therapy Profile Questionnaire) that was generated via Survey Monkey.  The link was active for four months.  Access was granted after the participant confirmed consent on the link that was provided.  The collected data was subjected to descriptive and empirical testing using the SPSS version 24.0.

Results: Twenty-seven (27) physiotherapists participated in the study.  Of the participants, 37% indicated having two to five years’ experience.  Three (3; 11.11%) of the 27 participants work exclusively with oncology patients, while the remaining participants (88.89%) treat oncology patients on an ad-hoc basis.  Participants favour the following treatment techniques in the management of CIPN: stability exercises (77.78%); soft tissue mobilisation (66.67%); sensory integration (66.67%); strengthening exercises (66.67%); proprioceptive neuromuscular facilitation (62.96%); stretching- and endurance exercises (59.26%); breathing exercises and activities of daily living training (55.56%).  A strong association is observed between the use of manual therapy and neuro-developmental techniques (0.968).

Conclusion(s): Cardiopulmonary therapy, therapeutic exercises, manual therapy- and neuro-developmental techniques are used by physiotherapists in the management of CIPN. These treatment techniques may address the patients’ needs on a sensory, motor and autonomic level.  Close to half of the participants do not use electrotherapy techniques.  Physiotherapy management strategies currently practiced in Pretoria are deemed to be in line with published research.  

Implications: Physiotherapists in Pretoria are managing CIPN in line with international practices.  Studies to determine the effectiveness of the management strategies within the wider South African context, however, should be conducted. Alternative management strategies, based on the pathophysiology of CIPN, could also be explored.

Funding, acknowledgements: No funding was received for the conduction of this study.

Keywords: physiotherapy, chemotherapy-induced peripheral neuropathy, intervention/management

Topic: Non-communicable diseases (NCDs) & risk factors

Did this work require ethics approval? Yes
Institution: Sefako Makgatho Health Sciences University
Committee: Sefako Makgatho Health Sciences University Research Ethics Committee
Ethics number: SMUREC/H/265/2017:PG

All authors, affiliations and abstracts have been published as submitted.

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