The purpose of this study is to determine the effectiveness of the EX-CIPN program in reducing the strength of CIPN symptoms and CIPN-related disability and improving the ability to complete everyday activities. This will be done by determining whether it is better to receive the EX-CIPN program or better to receive no additional intervention. To do this, some of the participants in this study will get EX-CIPN and others will receive usual care. Those who receive usual care will be offered EX-CIPN upon study completion. The main question it aims to answer is:
• Is EX-CIPN effective in improving CIPN symptoms for cancer survivors experiencing persistent CIPN?
Participants in both study groups will be asked to:
• Complete assessments at baseline, immediately post-intervention, and 3-months post-intervention
Participants in the EX-CIPN group will be asked to:
* Complete an additional aassessment at 6-months post-intervention * Complete a 10-week remote, individualized exercise program * Receive health coaching calls on weeks 2, 3, 4, 6, and 8 of the intervention * Wear a FitBit throughout the study to track physical activity and promote behaviour change
diagnosed with any type of cancer
received chemotherapy treatment as part of curative-intent therapy (no minimum dose)
>6 months following chemotherapy completion with no current plans for further chemotherapy
report Grade 1 or higher on the numbness and tingling severity item of the Common Terminology Criteria for Adverse Events (CTCAE) v 5.0
currently meeting all recommendations from the physical activity guidelines for cancer survivors
have any neurological conditions influencing cognition (i.e. dementia, Alzheimer's) and preventing safe or appropriate engagement with exercise recommendation
have neuropathy that pre-existed chemotherapy receipt (i.e. diabetic neuropathy)
currently enrolled in other rehabilitation or exercise-based interventions
Parallel
EX-CIPN
BehavioralThe 10-week intervention includes: Individualized Exercise Program: Each participant will receive an individualized progressive exercise program that includes cardiovascular and strength training as well as balance and desensitization exercises specific to CIPN symptoms. Remote Monitoring: Fitbit™ devices will be used to monitor patients' physical activity over the duration of the program. Fitness trackers can promote behaviour change. Remote Person-to-Person Clinical Support: Participants will have scheduled remote check-ins and health coaching sessions with their assigned RKin on weeks 2, 3, 4, 6, and 8 of the intervention. During these calls, the RKin will progress the exercise program as needed, discuss and develop goals, and identify potential barriers and solutions in achieving their goals. After the 10-week intervention participants will receive a 3-month maintenance phase with 2 monthly remote check-ins.
CIPN Symptoms
Measured using the European Organisation for Research and Treatment of Cancer Chemotherapy-Induced Peripheral Neuropathy (EORTC CIPN-20) questionnaire. Results are scored on a scale between 20-80 with higher scores meaning worse outcomes.
CIPN-related disability
Measured using the Rasch-built Overall Disability Scale for patients with chemotherapy-induced peripheral neuropathy CIPN-R-ODS. Results are scored on a scale between 0-56 with lower scores meaning worse outcomes.
Strength (Upper Body)
Measured via handgrip dynamometry or grip strength test (GST).
Strength (Lower Body)
Measured by a 30-second sit to stand test (30-s STS).
Balance
Measured using the 7-Item Berg Balance Test. The test provides a score from 0 to 28 with lower scores meaning worse outcomes.
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