Sensory Rehabilitation in Chemo Induced Peripheral Neuropathy

NCT ID: NCT06724861

Last Updated: 2024-12-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

27 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-12-11

Study Completion Date

2026-12-11

Brief Summary

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This study is a cross-over RCT evaluating the effectiveness of 3 sessions a week apart of explicit sensory retraining to the lower extremities in individuals with CIPN versus usual care. The primary outcome measures are TNAS for subjective symptoms, VAS for pain and TUG for mobility. Additional outcome measures are FABS for balance, sensory assessments - monofilaments for touch threshold, LEPT for proprioception, a home exercise log and a satisfaction questionnaire.

Detailed Description

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Chemotherapy Induced Peripheral Neuropathy (CIPN) is a neurological complication of chemotherapy, affecting between 50%-90% of the patients: up to 68% within the first month after chemotherapy, 60% after 3 months, and 30% after 6 months.

Neuropathic symptoms can persist in 11% to more than 80% of individuals post chemotherapy at one to three years following treatment and around 50% even after 5 years and more.

CIPN is associated with lower self-reported physical function and Quality of Life (QoL).

The clinical picture is typically sensory, with involvement of large and small sensory fibers. Motor and autonomic involvement is less frequent.

Damage to sensory nerve fibers is typically symmetrical. Sensory loss in a 'glove and stocking type' distribution leads to 'minus' symptoms (loss of function) including numbness in hands and feet, impaired perception of light touch, hypoalgesia and impaired proprioception, temperature and vibration sensation. Paradoxically, 'plus' features (gain of function) such as paresthesia (tingling like pins and needles), dysesthesia, allodynia and hyperalgesia appear simultaneously. CIPN can be functionally debilitating including impaired balance, walking slower and shorter steps and increased falls.

Active, explicit sensory rehabilitation is efficient in promoting sensation and function in individuals with neurological conditions, such as stroke and multiple sclerosis. To the best of our knowledge although CIPN is primarily a sensory deficit there is no treatment aimed at this aspect. We aim to conduct a pilot study to explore the feasibility and clinical benefit of an active, explicit sensory rehabilitation protocol for the lower limb in individuals with chronic CIPN.

This study is a cross-over RCT evaluating the effectiveness of 3 sessions a week apart of explicit sensory retraining to the lower extremities in individuals with CIPN versus usual care. The primary outcome measures are TNAS for subjective symptoms, VAS for pain and TUG for mobility. Additional outcome measures are FABS for balance, sensory assessments - monofilaments for touch threshold, LEPT for proprioception, a home exercise log and a satisfaction questionnaire.

Conditions

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CIPN - Chemotherapy-Induced Peripheral Neuropathy Age Over 18 Chemotherapy-induced Peripheral Neuropathy

Keywords

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Neuropathic pain Chemo Induced Peripheral Neuropathy (CIPN) Sensory rehabilitation Explicit Sensory Retraining Lower extremity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

A Randomized Controlled Trial will be conducted in a within-subject cross-over design (AB BA). Full assessments will be conducted at baseline, after last treatment session. A short assessment will be conducted at the beginning of all sessions. The early intervention group (AB) will be assessed at one-month follow-up in addition. The later intervention group (BA) will be assessed at baseline, and after a month before treatment commences and immediately after last treatment
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
The outcome assessor will not be aware of randomization and allocation. Primary investigator and statistician will receive data ready for analysis.

Study Groups

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AB - early experimental treatment, later control usual care

AB - early experimental treatment, later control usual care

Group Type OTHER

Explicit Sensory Retraining for the lower extremities

Intervention Type OTHER

Sensory retraining of detection, discrimination, quantification of a stimuli and recognition of stimuli and objects with the leg and mainly with the foot. Top-down awareness of bottom-up sensory experience in the treatment session and in everyday life.

no treatment

Intervention Type OTHER

Usual care

BA - early control usual care, later experimental treatment

BA - early control usual care, later experimental treatment

Group Type OTHER

Explicit Sensory Retraining for the lower extremities

Intervention Type OTHER

Sensory retraining of detection, discrimination, quantification of a stimuli and recognition of stimuli and objects with the leg and mainly with the foot. Top-down awareness of bottom-up sensory experience in the treatment session and in everyday life.

no treatment

Intervention Type OTHER

Usual care

Interventions

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Explicit Sensory Retraining for the lower extremities

Sensory retraining of detection, discrimination, quantification of a stimuli and recognition of stimuli and objects with the leg and mainly with the foot. Top-down awareness of bottom-up sensory experience in the treatment session and in everyday life.

Intervention Type OTHER

no treatment

Usual care

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* CIPN by self-report (present or absent) \> 3 months after last chemotherapy treatment
* age \> 18.

Exclusion Criteria

* Pre-chemotherapy neuropathy/ sensory impairment
* recurrent falls prior to chemotherapy (more than 2 per year)
* CNS involvement
* not ambulatory before chemotherapy
* Hebrew proficiency not meeting questionnaires' needs.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Zefat Academic College

OTHER

Sponsor Role collaborator

Assaf-Harofeh Medical Center

OTHER_GOV

Sponsor Role lead

Responsible Party

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Rotem Merose

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Asaph-Harofe Shamir Medical Center

Rishon LeZiyyon, , Israel

Site Status

Countries

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Israel

Central Contacts

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Hadas Ofek, PT, PhD

Role: CONTACT

Phone: +972544666412

Email: [email protected]

Rotem Merose, MD

Role: CONTACT

Email: [email protected]

Other Identifiers

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CIPN - RCT

Identifier Type: -

Identifier Source: org_study_id