Date of Award

Spring 2-23-2016

Degree Type

Dissertation

Degree Name

PhD Health Sciences

Department

Health and Medical Sciences

Advisor

Genevieve Pinto Zipp, Ed.D

Committee Member

Fortunato Battaglia, Ph.D

Committee Member

Rebecca Moss, Ph.D

Committee Member

Stephanie Bryan, Ph.D

Keywords

cancer survivors, falls, gait, peripheral neuropathy, chemotherapy

Abstract

Background: Cancer patients undergoing chemotherapy often experience chemotherapy-induced-peripheral-neuropathy, which reportedly causes gait disturbances that may increase their risk for falls. Falls are a significant event because they have been linked to serious injuries and disabilities, loss of independence, and increased mortality rates. Purpose: The purpose of this study was to assess whether chemotherapy-induced peripheral neuropathy is associated with spatiotemporal gait adaptations in posttreatment adult cancer survivors when compared to healthy, disease-free, age and morphologically matched controls. Methods: In a quasi-experimental design, 16 subjects participated in the present study. There were 8 CIPN subjects between the ages of 50–70 years of age who had a histologically confirmed stage 2–3 breast or colorectal cancer diagnosis with a confirmed treatment plan consisting of taxane- or oxaliplatin-based chemotherapy. Controls consisted of 8 age and morphologically matched subjects. The primary outcome consisted of spatiotemporal gait parameters as computed using the GAITRite walkway and software. Secondary outcomes consisted of determining fall risk using the Timed Up & Go test. Results: Gait velocity for CIPN patients (110. 75 cm/s, SD = 26.79), was significantly slower than gait velocity of the controls (147.79 cm/s, SD = 11.69). Step length was significantly shorter for CIPN (53.92 cm, SD = 23.55) when compared to the controls (77.15 cm, SD = 5.28). Lastly, CIPN participants had a significantly higher TUG Score (12.33 s, SD 6.25) compared to the controls (6.62 s, SD = 1.10). Conclusion: Cancer patients with CIPN displayed a slower walking velocity and shorter step length compared to healthy age and morphologically matched controls. Additional gait patterns, such as step time, step length, base of support, swing time, single support time, and double support time, were not significantly different. Also, the mean TUG score for CIPN patients were not only significantly greater than the controls, but were also above the clinical fall risk cut off of 10.7 s, indicating fall risk. While gait speed and step length were the only significant gait variables, as noted in the literature they are key indicator for fall risk.

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