Category: Cancer Rehabilitation; Pain Rehabilitation; Complementary Integrative Rehabilitation Medicine
Objective : Chemotherapy-induced peripheral neuropathy syndrome causes significant pain in hands and feet and is an adverse effect of treatment. This is the first study to explore a somatic yoga and meditation intervention on functional outcomes and quality of life.
Design : Pilot study.
Setting : Bacharach Institute for Rehabilitation in Galloway, NJ.
Participants (or Animals, Specimens, Cadavers) : Ten participants with median age 64.4 years (47-81) attended 61% of the sessions.
SYM was provided twice a week for 8 weeks for 1.5 hours and participants completed home-based SYM and journal entries. Home practice was implemented during week 1 of the sessions and participants were asked to record home practice.
Main Outcome Measure(s) : Primary functional outcomes included Sit and Reach, Functional Reach and Timed Up and Go. Self-reported Patient Neurotoxicity Questionnaire, FACT-GOG-NTX, Brief Pain Inventory, Perceived Stress Scale, Pittsburgh Sleep Quality Index, FACIT-Spirituality and Falls Efficacy Scale were secondary outcomes. Biomarkers included salivary cortisol (stress) and bioesthesiometer (vibration).
Quantitative Findings: Significant improvements were found in flexibility (p=0.006); balance (p=0.001) and gait speed (p=0.004). Pain severity (p=0.041) and pain interference reduced (p=0.011). PNQ was significant (p=0.003) and stress (PSS) reduced (p=0.056). Sleep, QOL (FACT-GOG-Ntx), and fear of falling measures improved but not significantly. Decreased cortisol trends (p=.116) with vibration sense improvements were achieved (p=0.035.)
Qualitative Findings: Five themes emerged through non-participant observations and participant journal entries, weekly in person conversations, through phone contact and e-mail, and mid and final focus group meeting transcription; and was confirmed among participants through member checks. Vacillation of CIPN pain perception over time; Transferability of skills to daily activities learned; Improvement in physical function leading to return to various work and hobbies; Perceived relaxation as an effect of SYM; Group engagement provided a social context for not feeling isolated with CIPN.
Conclusions : Preliminary data suggests that SYM may improve QOL and flexibility, gait speed and balance in cancer survivors with CIPN. Eight participants were high risk for falls as measured by FR and none were fall risk at the end of the intervention.
Mary Lou Galantino– Professor of Physical Therapy, Stockton University, Galloway, New Jersey