Whole body vibration helpful in peripheral neuropathy?
A common side effect of cancer treatment with chemotherapy is chemotherapy-induced peripheral neuropathy (CIPN), with considerable negative effects on QoL in cancer survivors. There is no pharmocological treatment available, and attention has been directed towards active rehabilitation in improving daily function.
A conceptual model has been proposed in which exercise, by increasing mitochondrial energy production and blood flow to the peripheral nervous system, may result in fewer neuropathic symptoms. Vibrating platforms or WBV training could be a possible modality.
Based on the 5 articles reviewed, the results of this literature search suggest a low level of evidence for a positive effect of WBV on muscle strength and balance and for no effect of WBV on neuropathic pain. However, there is a strong conceptual framework for WBV and CIPN that needs to be explored in high-quality research.
CIPN often occurs in cancer treatment with platinum agents, a number of antimitotic drugs and bortezomib. These neurotoxic agents target the nervous system at different sites, including the dorsal root ganglions, and the microtubules, ion channels and blood vessels of peripheral axons.
Symptoms are dose-dependent, and mostly sensory (e.g. pain, loss of sensibility) but they can also manifest as motor weakness or autonomic dysfunction.
Damage of small fibers causes pain, hyperesthesia and loss of pain and temperature senses, while injury to large fibers produces loss of vibration sense, loss of proprioception and muscle weakness. There is no known treatment, and CIPN can have a significantly negative long-term effect on daily activities and quality of life in cancer survivors.
Rehabilitation training may play an important role in the recovery process and improving ADL in patients with CIPN, and WBV training could be a suitable modality targeting strenght, balance and joint stability, areas that are problematic in CIPN.
There seems to be a growing evidence base justifying the interest in the possible advantages of WBV in both the fields of sports and medicine, despite controversial results.
However, the potential effects of WBV on muscle strength (facilitating neuromuscular conditioning by stabilizing joints via the tonic vibration reflex) balance (for obvious reasons) and neuropathic pain are promising.
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> From: Verhulst et al., Oncol Rev 9 (2016) 263. All rights reserved to The Author(s). Click here for the Pubmed summary.