Streckmann, F., Kneis, S., Leifert, J.A., Baumann, F.T., Kleber, M., Ihorst, G., . . . Bertz, H. (2014). Exercise program improves therapy-related side-effects and quality of life in lymphoma patients undergoing therapy. Annals of Oncology, 25, 493–499.

To test the hypothesis that an exercise program for aerobic endurance, sensorimotor training, and strength training would improve neuromuscular function, improve balance control, and reduce peripheral neuropathy side effects in patients with lymphoma

Patients were randomly assigned to the training intervention or control group. The training intervention was provided twice weekly for 36 weeks under the supervision of a certified sport therapist or physiotherapist. Aerobic endurance training was done on a treadmill or bicycle dynamometer for 10–20 minutes. Four postural stabilization tasks were carried out with increasing task difficulty and surface instability. Resistance exercises with a theraband were included for strength training. Study measures were obtained prior to chemotherapy and after 12, 24, and 36 weeks. Both groups were asked to maintain a weekly diary of physical activities.

• N = 56  
• MEAN AGE = 46 years (range = 19–73 years)
• MALES: 77%, FEMALES: 23%
• KEY DISEASE CHARACTERISTICS: Patients with Hodgkin disease, multiple myeloma, or non-Hodgkin lymphoma
• OTHER KEY SAMPLE CHARACTERISTICS: At baseline, before the intervention, 37 patients had already begun treatment with neurotoxic drugs, and nine patients had symptoms of peripheral neuropathy.

• SITE: Single-site    
• SETTING TYPE: Outpatient    
• LOCATION: Germany

• PHASE OF CARE: Active antitumor treatment

Randomized, controlled trial

• Tuning fork evaluation of sensitivity
• Activity level diary
• Pressure displacement measurement for balance
• Subjective global assessment questionnaire for side effects monitoring

During the first 12 weeks, there were significant differences between the groups in aspects of quality of life; however, there was no difference between the groups after 36 weeks. The incidence of reduced peripheral deep sensitivity was lower in the intervention group compared to the control group (p = 0.002), and this symptom diminished in 87.5% of those in the intervention group. No symptoms declined in the control group. Those in the intervention group had a greater improvement in time to regain balance than those in the control group, but this difference was not significant. There were differences between groups in various aspects of balance control and ability to complete attempts for balance control.

The training intervention provided here demonstrated some benefits for reductions in peripheral neuropathy symptoms and some aspects of balance control.

• Small sample (< 100)
• Risk of bias (no blinding)
• Risk of bias (no appropriate attentional control condition)
• Measurement/methods not well described
• Other limitations/explanation: The specific method of measurement of quality of life was not stated even though quality of life was the primary outcome of this study. The individual, specific sensory-motor measurements were difficult to interpret in terms of overall comprehensive effect because aspects of measurement varied in their results and data presentation.

Sensory-motor training may be beneficial for reducing symptoms of peripheral neuropathy and improving at-risk patients’ balance and motor function. Additional, well designed research studies with larger samples are warranted.