The Detrimental Association Between Fear of Falling and Motor Performance in Older Cancer Patients with Chemotherapy-Induced Peripheral Neuropathy

Authors

Gu Eon Kang
Tamiko K Murphy
Mark E Kunik
Hoda J Badr
Biruh T Workeneh
Sarvari V Yellapragada
Yvonne H Sada
Bijan Najafi

Publication Date

7-1-2021

Journal

Gait Posture

DOI

10.1016/j.gaitpost.2021.05.022

PMID

34091147

PMCID

PMC8316411

PubMedCentral® Posted Date

7-1-2022

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Accidental Falls, Aged, Antineoplastic Agents, Fear, Gait, Humans, Neoplasms, Peripheral Nervous System Diseases, Chemotherapy-induced peripheral neuropathy, fear of falling, gait speed, postural sway, wearable sensors

Abstract

BACKGROUND: Cancer patients with chemotherapy-induced peripheral neuropathy (CIPN) are at increased risk of falls and developing fear of falling (FoF). Although FoF may continue to impair motor performance and increase the risk of falling even further, this association remains unexplored in CIPN.

RESEARCH QUESTION: Does high FoF in patients with CIPN further deteriorate motor performance beyond the impairment from CIPN-related sensory deficits?

METHODS: In this secondary analysis of data collected from two clinical trials, gait parameters during habitual walking condition and postural sway parameters during 30-second quiet standing (eye-open and eyes-closed) were compared among older participants (≥ 65 years) with CIPN and high FoF (CIPN FoF+; n=16), older participants with CIPN and low FoF (CIPN FoF-; n=19) and normal older controls (i.e., non-cancer, non-diabetic, non-neurologic, and non-orthopedic; n=16). We measured gait and postural sway parameters using wearable sensors (BioSensics, Newton, MA, USA), and FoF severity using the Falls Efficacy Scale-International.

RESULTS: The largest between-group differences were found in gait speed. The CIPN FoF + group had significantly slower gait speed (0.78 ± 0.21 m/s) than the CIPN FoF- (0.93 ± 0.17 m/s) and normal control groups (1.17 ± 0.13 m/s) (all p < .05; effect sizes = 0.79 and 2.23, respectively). We found a significant association between gait speed and FoF severity (R2 = 0.356; p < .001) across all participants with CIPN. Among participants with CIPN, no significant differences in postural sway parameters were found between the CIPN FoF+and CIPN FoF- groups.

SIGNIFICANCE: Our results suggest that gait performance further deteriorates in patients with CIPN and high FoF beyond the impairment from CIPN-related sensory deficits. Our results also suggest further research is needed regarding FoF, and fall risk, as FoF is a simple tool that healthcare providers can use in clinical practice.