University of South Florida

$2.2 million NIH grant may help breast cancer survivors improve gait, balance and strength impacted by chemotherapy

(TAMPA, FL, Oct 1, 2019) – USF Health nursing researcher Constance Visovsky, PhD, RN, ACNP, FAAN, has been awarded a $2.2 million grant from the National Institutes of Health’s National Cancer Institute to study whether a home-based exercise regimen to help improve gait and balance and strengthen muscles could lessen adverse neuromuscular effects many breast cancer survivors face after chemotherapy.

In a five-year study titled “Home-Based Physical Activity Intervention for Taxane-Induced CIPN,” Dr. Visovsky, the principal investigator, will examine whether the 16-week exercise program can decrease the severity of nerve and muscle symptoms from chemotherapy-induced peripheral neuropathy (CIPN).

The research study is significant because it is the first to test the home delivery of an exercise intervention aimed at cancer patients who continue to suffer from CIPN – an irreversible condition characterized by pain, numbness, tingling in the extremities, and impaired gait and balance related to receiving the common class of cancer drugs called taxanes.

“If successful, it will provide the only evidence-based intervention for patients suffering from persistent neuropathy from chemotherapy,” said Dr. Visovsky, associate professor in the University of South Florida College of Nursing. “And it can be delivered in the home, so it’s easily translated to clinical practice.”

Dr. Visovsky and her team will recruit 312 women with breast cancer who have completed their taxane chemotherapy treatments for at least a year, but who still report CIPN.

Half of the women will undergo the home-based resistance strength training plus a gait and balance exercise program while keeping an exercise journal.  The remaining 156 will receive an attention control program of educational materials on cancer survivorship. The study will assess each participant’s lower extremity muscle strength, gait and balance, nerve conduction, neuropathy symptoms and quality of life every four weeks for 16 weeks.

Specifically, participants will undergo a sophisticated gait and motion analysis at the USF Health School of Physical Therapy and Rehabilitation Sciences. Researchers in the USF Health Department of Neurology will perform nerve conduction studies to measure peripheral sensory and motor functions. Researchers will also collect different variables that may confound the results, such as a patients’s age, body mass index, the number of chemotherapy cycles received, and any medications taken to treat neuropathic pain, Dr. Viscovsky said.

Dr. Visovsky has conducted research on the neuromuscular effects of cancer chemotherapy for over 20 years, and is hopeful this intervention could help lessen the painful symptoms, reduce the risk of fall and injury, and ultimately improve a breast cancer survivor’s quality of life.

She will work with a team of USF Health researchers who specialize in biostatistics, neurology, physical therapy and rehabilitation sciences.

The study’s co-investigators include College of Nursing professor Ming Ji, PhD; USF Health Morsani College of Medicine neurology professor Tuan Vu, MD; associate professor Douglas Haladay, DPT; and assistant professor Patricia Teran Wodzinski, PT. Ellen Eckelman, a physical therapist at Tampa General Hospital, will be a study consultant.

Story by Elizabeth L. Brown, USF College of Nursing.

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