Using wearables to screen motor performance deterioration because of cancer and chemotherapy-induced peripheral neuropathy (CIPN) in adults - Toward an early diagnosis of CIPN

Mohsen Zahiri; Kevin M. Chen; He Zhou; Hung Nguyen; Biruh T. Workeneh; Sarvari V. Yellapragada; Yvonne H. Sada; Michael Schwenk; Bijan Najafi

doi:10.1016/j.jgo.2019.01.010

Using wearables to screen motor performance deterioration because of cancer and chemotherapy-induced peripheral neuropathy (CIPN) in adults - Toward an early diagnosis of CIPN

Mohsen Zahiri, Kevin M. Chen, He Zhou, Hung Nguyen, Biruh T. Workeneh, Sarvari V. Yellapragada, Yvonne H. Sada, Michael Schwenk, Bijan Najafi

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Abstract

Objective: An essential component for optimizing quality of life in adults with cancer is determining the degree to which therapy may negatively impact motor-performance, so that patients can maintain their quality of life and independence. This study examined whether instrumented gait and balance could determine the magnitude of deterioration in motor-performance from chemotherapy-induced peripheral neuropathy (CIPN). Methods: We recruited 84 adults with cancer (age = 71.1 ± 9.7 years old, BMI = 26.8 ± 6.2 kg/m², gender = 56%female) and 57 age-matched non-cancer patients (age = 69.5 ± 9.8 years old, BMI = 27.1 ± 6.0 kg/m², gender = 79%female). Based on clinical screening, the group with cancer was classified into two groups: participants with CIPN (CIPN+) and without CIPN (CIPN-). Gait and balance were quantified using validated wearables. The Vibration Perception Threshold (VPT) test was used to stratify the CIPN+ group into mild (Mild-CIPN) and severe (Severe-CIPN) subgroups. Results: All gait and balance parameters were deteriorated in the group with cancer compared to non-cancer group with the largest effects observed for stride-time (11%, Cohen's effect size d = 1.00, p < 0.001) and eyes-closed ankle sway (94%, d = 0.49, p = 0.001). The same trend was observed when the Severe-CIPN subgroup was compared to the Mild-CIPN. VPT correlates significantly with motor deterioration, with the largest correlation found in stride-time (Rho = 0.37, p = 0.007). Severe-CIPN subjects were significantly older and overall had more deterioration in the majority of motor-performance parameters after adjusting for age (p < 0.050). Conclusion: These results confirmed the negative impact of CIPN on motor-performance with the largest effects on ankle stability and stride-time. VPT is a predictor of motor deterioration and may be used to determine the severity of CIPN symptom.

Original language	English (US)
Pages (from-to)	960-967
Number of pages	8
Journal	Journal of Geriatric Oncology
Volume	10
Issue number	6
DOIs	https://doi.org/10.1016/j.jgo.2019.01.010
State	Published - Nov 2019

Keywords

Adults with cancer
Balance
Chemotherapy-Induced Peripheral Neuropathy
Falls
Gait
Motor performance
Neuropathy
Plantar numbness
Wearables

ASJC Scopus subject areas

Oncology
Geriatrics and Gerontology

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10.1016/j.jgo.2019.01.010

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Zahiri, M., Chen, K. M., Zhou, H., Nguyen, H., Workeneh, B. T., Yellapragada, S. V., Sada, Y. H., Schwenk, M., & Najafi, B. (2019). Using wearables to screen motor performance deterioration because of cancer and chemotherapy-induced peripheral neuropathy (CIPN) in adults - Toward an early diagnosis of CIPN. Journal of Geriatric Oncology, 10(6), 960-967. https://doi.org/10.1016/j.jgo.2019.01.010

Zahiri, M, Chen, KM, Zhou, H, Nguyen, H, Workeneh, BT, Yellapragada, SV, Sada, YH, Schwenk, M & Najafi, B 2019, 'Using wearables to screen motor performance deterioration because of cancer and chemotherapy-induced peripheral neuropathy (CIPN) in adults - Toward an early diagnosis of CIPN', Journal of Geriatric Oncology, vol. 10, no. 6, pp. 960-967. https://doi.org/10.1016/j.jgo.2019.01.010

@article{e15d8247b794463a9b2a72c0af3aa9c8,

title = "Using wearables to screen motor performance deterioration because of cancer and chemotherapy-induced peripheral neuropathy (CIPN) in adults - Toward an early diagnosis of CIPN",

abstract = "Objective: An essential component for optimizing quality of life in adults with cancer is determining the degree to which therapy may negatively impact motor-performance, so that patients can maintain their quality of life and independence. This study examined whether instrumented gait and balance could determine the magnitude of deterioration in motor-performance from chemotherapy-induced peripheral neuropathy (CIPN). Methods: We recruited 84 adults with cancer (age = 71.1 ± 9.7 years old, BMI = 26.8 ± 6.2 kg/m2, gender = 56%female) and 57 age-matched non-cancer patients (age = 69.5 ± 9.8 years old, BMI = 27.1 ± 6.0 kg/m2, gender = 79%female). Based on clinical screening, the group with cancer was classified into two groups: participants with CIPN (CIPN+) and without CIPN (CIPN-). Gait and balance were quantified using validated wearables. The Vibration Perception Threshold (VPT) test was used to stratify the CIPN+ group into mild (Mild-CIPN) and severe (Severe-CIPN) subgroups. Results: All gait and balance parameters were deteriorated in the group with cancer compared to non-cancer group with the largest effects observed for stride-time (11%, Cohen's effect size d = 1.00, p < 0.001) and eyes-closed ankle sway (94%, d = 0.49, p = 0.001). The same trend was observed when the Severe-CIPN subgroup was compared to the Mild-CIPN. VPT correlates significantly with motor deterioration, with the largest correlation found in stride-time (Rho = 0.37, p = 0.007). Severe-CIPN subjects were significantly older and overall had more deterioration in the majority of motor-performance parameters after adjusting for age (p < 0.050). Conclusion: These results confirmed the negative impact of CIPN on motor-performance with the largest effects on ankle stability and stride-time. VPT is a predictor of motor deterioration and may be used to determine the severity of CIPN symptom.",

keywords = "Adults with cancer, Balance, Chemotherapy-Induced Peripheral Neuropathy, Falls, Gait, Motor performance, Neuropathy, Plantar numbness, Wearables",

author = "Mohsen Zahiri and Chen, {Kevin M.} and He Zhou and Hung Nguyen and Workeneh, {Biruh T.} and Yellapragada, {Sarvari V.} and Sada, {Yvonne H.} and Michael Schwenk and Bijan Najafi",

note = "Funding Information: Partial support was provided by the USA National Institutes of Health/National Cancer Institute (award number 1R21CA190933-01A1 ). The content is solely the responsibility of the authors and does not necessarily represent the official views of sponsor. We thank Linda Garland, Ana Enriquez, Ivan Marin, Louie Mersey, and Manual Gardea for assisting with data collection, data analysis, and coordination of this research study between involved key investigators. Publisher Copyright: {\textcopyright} 2019 The Authors",

year = "2019",

month = nov,

doi = "10.1016/j.jgo.2019.01.010",

language = "English (US)",

volume = "10",

pages = "960--967",

journal = "Journal of Geriatric Oncology",

issn = "1879-4068",

publisher = "Elsevier Ltd",

number = "6",

}

TY - JOUR

T1 - Using wearables to screen motor performance deterioration because of cancer and chemotherapy-induced peripheral neuropathy (CIPN) in adults - Toward an early diagnosis of CIPN

AU - Zahiri, Mohsen

AU - Chen, Kevin M.

AU - Zhou, He

AU - Nguyen, Hung

AU - Workeneh, Biruh T.

AU - Yellapragada, Sarvari V.

AU - Sada, Yvonne H.

AU - Schwenk, Michael

AU - Najafi, Bijan

N1 - Funding Information: Partial support was provided by the USA National Institutes of Health/National Cancer Institute (award number 1R21CA190933-01A1 ). The content is solely the responsibility of the authors and does not necessarily represent the official views of sponsor. We thank Linda Garland, Ana Enriquez, Ivan Marin, Louie Mersey, and Manual Gardea for assisting with data collection, data analysis, and coordination of this research study between involved key investigators. Publisher Copyright: © 2019 The Authors

PY - 2019/11

Y1 - 2019/11

N2 - Objective: An essential component for optimizing quality of life in adults with cancer is determining the degree to which therapy may negatively impact motor-performance, so that patients can maintain their quality of life and independence. This study examined whether instrumented gait and balance could determine the magnitude of deterioration in motor-performance from chemotherapy-induced peripheral neuropathy (CIPN). Methods: We recruited 84 adults with cancer (age = 71.1 ± 9.7 years old, BMI = 26.8 ± 6.2 kg/m2, gender = 56%female) and 57 age-matched non-cancer patients (age = 69.5 ± 9.8 years old, BMI = 27.1 ± 6.0 kg/m2, gender = 79%female). Based on clinical screening, the group with cancer was classified into two groups: participants with CIPN (CIPN+) and without CIPN (CIPN-). Gait and balance were quantified using validated wearables. The Vibration Perception Threshold (VPT) test was used to stratify the CIPN+ group into mild (Mild-CIPN) and severe (Severe-CIPN) subgroups. Results: All gait and balance parameters were deteriorated in the group with cancer compared to non-cancer group with the largest effects observed for stride-time (11%, Cohen's effect size d = 1.00, p < 0.001) and eyes-closed ankle sway (94%, d = 0.49, p = 0.001). The same trend was observed when the Severe-CIPN subgroup was compared to the Mild-CIPN. VPT correlates significantly with motor deterioration, with the largest correlation found in stride-time (Rho = 0.37, p = 0.007). Severe-CIPN subjects were significantly older and overall had more deterioration in the majority of motor-performance parameters after adjusting for age (p < 0.050). Conclusion: These results confirmed the negative impact of CIPN on motor-performance with the largest effects on ankle stability and stride-time. VPT is a predictor of motor deterioration and may be used to determine the severity of CIPN symptom.

AB - Objective: An essential component for optimizing quality of life in adults with cancer is determining the degree to which therapy may negatively impact motor-performance, so that patients can maintain their quality of life and independence. This study examined whether instrumented gait and balance could determine the magnitude of deterioration in motor-performance from chemotherapy-induced peripheral neuropathy (CIPN). Methods: We recruited 84 adults with cancer (age = 71.1 ± 9.7 years old, BMI = 26.8 ± 6.2 kg/m2, gender = 56%female) and 57 age-matched non-cancer patients (age = 69.5 ± 9.8 years old, BMI = 27.1 ± 6.0 kg/m2, gender = 79%female). Based on clinical screening, the group with cancer was classified into two groups: participants with CIPN (CIPN+) and without CIPN (CIPN-). Gait and balance were quantified using validated wearables. The Vibration Perception Threshold (VPT) test was used to stratify the CIPN+ group into mild (Mild-CIPN) and severe (Severe-CIPN) subgroups. Results: All gait and balance parameters were deteriorated in the group with cancer compared to non-cancer group with the largest effects observed for stride-time (11%, Cohen's effect size d = 1.00, p < 0.001) and eyes-closed ankle sway (94%, d = 0.49, p = 0.001). The same trend was observed when the Severe-CIPN subgroup was compared to the Mild-CIPN. VPT correlates significantly with motor deterioration, with the largest correlation found in stride-time (Rho = 0.37, p = 0.007). Severe-CIPN subjects were significantly older and overall had more deterioration in the majority of motor-performance parameters after adjusting for age (p < 0.050). Conclusion: These results confirmed the negative impact of CIPN on motor-performance with the largest effects on ankle stability and stride-time. VPT is a predictor of motor deterioration and may be used to determine the severity of CIPN symptom.

KW - Adults with cancer

KW - Balance

KW - Chemotherapy-Induced Peripheral Neuropathy

KW - Falls

KW - Gait

KW - Motor performance

KW - Neuropathy

KW - Plantar numbness

KW - Wearables

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DO - 10.1016/j.jgo.2019.01.010

M3 - Article

AN - SCOPUS:85060110679

SN - 1879-4068

VL - 10

SP - 960

EP - 967

JO - Journal of Geriatric Oncology

JF - Journal of Geriatric Oncology

IS - 6

ER -

Using wearables to screen motor performance deterioration because of cancer and chemotherapy-induced peripheral neuropathy (CIPN) in adults - Toward an early diagnosis of CIPN

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