Streckmann, F., Zopf, E., Lehmann, H., May, K., Rizza, J., Zimmer, P., . . . Baumann, F. (2014). Exercise intervention studies in patients with peripheral neuropathy: A systematic review. Sports Medicine, 44, 1289–1304.
PHASE OF CARE: Multiple phases of care
Five studies assessed the influence of balance training on the side effects of PNP and showed a significant impact on balance control. Two studies also showed improved gait parameters. Improved motor, sensory, and metabolic symptoms was observed with tai chi. Combinations of endurance, balance, and strengthening exercises showed a positive effect on motor performance only if exercises were performed standing or walking. One RCT in chemotherapy-induced PNP showed that exercise (sensorimotor, endurance, and resistance training) can reduce quality of life, level of activity, and sensitivity. Only three studies in the cohort of those with PNP from various causes showed they were able to achieve improvements through the exercise regimen. The other three studies in this group showed no significant changes after intervention. None of the studies reported serious adverse effects, although one of the diabetic neuropathy studies reported one calf strain from treadmill walking.
Evidence for exercise interventions in those with PNP has improved, although study quality is diverse. Overall, the quality of studies included in this review was 2b with the best evidence in those with diabetes and PNP. Current data suggest that exercise is feasible, safe, and beneficial. Exercise compliance was overall good, and only mild adverse events were reported. Specific treatment for nerve damage was not available, and the efficacy of pharmaceutical interventions is questionable.
Patient cohorts were very heterogeneous. Because of the heterogeneity, the results are not very generalizable. Eighteen studies were included (small sample).
More research is needed on exercise interventions, particularly in regard to the patients with cancer who have other symptoms to contend with as well. Nurses should educate patients about PNP and encourage enrollment in clinical trials if available.