How Exercise Can Help Neuropathy


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Nancy Campbell, MS, an exercise physiologist with Dana-Farber's Adult Survivorship Program, provides some tips and exercises that can help manage the symptoms of neuropathy. This presentation was originally given on March 27, 2013 through Dana-Farber's Blum Resource Center.

  • @STARFISHZZB - Thank you so much for your thoughtful comment. We are so happy to hear that this presentation is providing you some helpful tips and, hopefully, some relief.

    Wishing you all the best!
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  • This workshop couldn't have come at a better time for me! I have had chemo induced neuropathy with past treatments & know how painful & unpleasant it is & how much it can impact day to day life. I have recently begun a new therapy that had reignited those symptoms & I was really struggling with how to deal with it all again. I was hoping to find something that I could turn to that wasn't a prescription or that was going to be too difficult or challenging or financially burdening to implement in my day to day life. This workshop provided some excellent, easy to follow, no cost tips & tools that I was able to walk away with & implement immediately. And more importantly, experience some relief from my symptoms. We all read & hear how exercise, in general, is beneficial to all for better health & it is even more apparent to me that it is an invaluable weapon in helping me deal not only with cancer related symptoms, but with achieving an overall better sense of well being & control of my body. I was fortunate to have been directed to this workshop & only wish that I had known about this sooner. I hope others are able to get this information & benefit from it. Thanks to all who put this together & for running a great & much needed workshop!
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How Exercise Can Help Neuropathy

  1. 1. Nancy Campbell, MS Exercise Physiologist Adult Survivorship Program March 27, 2014
  2. 2. Agenda  What is chemotherapy induced peripheral neuropathy (CIPN)?  How exercise may help with symptoms  Practice exercises
  3. 3. What is Chemotherapy Induced Peripheral Neuropathy (CIPN)?  A group of neuromuscular symptoms that result from nerve damage caused by drug therapies used during cancer treatment  Affects 30-90% of patients getting specific neurotoxic chemotherapy drugs  The most commonly used classes of drugs causing CIPN are taxanes (Taxol and Taxotere) and platinum based drugs (Cisplatin and Oxaliplatin)
  4. 4. Symptoms  Vary from person to person based on type of treatment and individual differences  Numbness, tingling and discomfort in the upper or lower extremities are the hallmark of CIPN  Can last for months to years after chemotherapy and sometimes is permanent  It can interfere with the ability to perform usual activities
  5. 5. Benefits of Exercise  People with neuropathy have reduced:  Proprioception  Sensation in lower extremities  Ankle strength  This can lead to increased risk for falls  Strength and balance training leads to fewer falls
  6. 6. How Exercise May Help Toftagen, C et al. Strength and Balance Training for Adults with Peripheral Neuropathy and High Risk of Fall. Onc Nurs For. 39, 5, 2012.
  7. 7. Tips for Foot Neuropathy If you have numbness in your feet you should:  Wear comfortable, properly fitting shoes  Avoid sandals, open toed or heeled shoes  Inspect feet daily for injury  Avoid walking barefoot or in socks alone  Always check for foreign objects in shoes before putting them on  Change shoes in the middle of the day  Consider making an appointment for physical or occupational therapy
  8. 8. Tips for Hand Neuropathy If you have numbness in your fingers you should:  Wear warm clothing in cold weather and protect hands from extreme cold  Use care when washing dishes or taking a bath or shower and do not let the water get too hot  Use potholders when cooking  Use gloves when washing dishes, gardening  Inspect skin for cuts, abrasions and burns  Consider making an appointment for physical or occupational therapy
  9. 9. Practice Exercises
  10. 10. Finger Rolls  Extend arms in front of you at shoulder height with palms facing away from you  Starting with your little finger, curl your hand into a fist one finger at a time  Rotate the fist to face you  Then open up your fingers one at a time, again starting with your little finger  Then rotate our palm back to the front  Repeat with your left hand  Do 4 sets of finger rolls Thriving After Breast Cancer. Sherry Lebed Davis and
  11. 11. Finger Roll with Fist  Extend your arms in front of you at shoulder height with palms facing ceiling  Starting with your little finger, curl your hand into a fist one finger at a time and make a fist  Squeeze the fist, then open up fingers, squeeze again  Do 4 sets of finger rolls
  12. 12. Finger Taps  Extend your arms in front of you at shoulder height with palms facing ceiling  Touch your little finger to your thumb, then ring finger, then middle finger, then index  Then unwind starting with index finger straightening, then middle finger, then ring  Do 4 sets of finger taps
  13. 13. Finger Taps  Place the palms of your hands in your lap  Lift the index finger twice and tap your lap  Repeat twice with each finger is succession  Do 4 sets of finger taps
  14. 14. Ankle Circles  Sit on the edge of a chair with knees bent at 90 degrees  Extend right leg straight  Perform 10 clockwise ankle circles  Perform 10 counter- clockwise ankle circles  Repeat with left leg
  15. 15. Standing Heel to Toe  Beginner: Stand and hold on to a chair for support.  Place right foot directly in front of left foot, eyes open, arms at side or across chest  Look straight ahead at stationary object  Hold for up to 30 seconds  Repeat with left foot in front  Intermediate: Stand without holding on to chair  Advanced: Repeat with eyes closed
  16. 16. Standing Side Leg  Stand next to a chair in an upright position, with feet together  Maintain your balance by gently touching the back of a chair with your right hand.  Raise your left leg in an outward motion, as far as possible. Make sure the left foot continues to point forward.  Hold for 2 seconds and return slowly to the starting position.  Make sure to keep your back straight as you raise your left leg. Your head, spine, and stationary leg should be aligned.  Keep your abdominal muscles engaged throughout the movement.  Repeat with the other leg.,20052.asp
  17. 17. Calf Raise  Stand with your feet hip distance apart, with a slight bend in your knees  While maintaining total body alignment, raise heels off the floor  Lower slowly and repeat  Lift for 3 counts, hold for 1-2 counts, lower for 4 counts  Perform 2 sets of 10 reps Progression:  Perform calf raise off a step for more range of motion
  18. 18. Calf Stretch  Place hands on wall at shoulder height  Extend one leg behind you in a lunging position  Make sure all 10 toes are facing forward, toward the wall in front of you  Bend your front knee, but make sure knees don’t extend over your toes  Stop movement when slight tension is felt and hold for 20-30 seconds
  19. 19. Resources Dana-Farber Adult Survivorship Program  Exercise consultation  or 617-632-4523  Women’s Strength Class  Tuesday 10-11, Friday 1:30-2:30  Dana-Farber Zakim Center  Acupuncture, massage, qi gong, yoga  or 617-632-3399  trial.aspx?tid=4207  Dana-Farber exercise research studies  Trials/Clinical-Trials-Search-Result.aspx?q=exercise
  20. 20. Resources    neuropathy-managing-this-nerve-wracking-problem     post_treatment_neuropathy_2012_07_17_2012-07-17 