Rhythmic Foot Embrocation According to Wegman/Hauschka for Alleviating Symptoms of Chemotherapy-Induced Peripheral Neuropathy : a Randomized Controlled Trial

Background

Chemotherapy-induced peripheral neuropathy (CIPN) in patients treated with platinum-, taxane- or vinca alkaloid-based chemotherapy may cause symptoms such as tingling, numbness, pain, and paresthesia, particularly in patients' hands and feet. This study aimed to evaluate rhythmic embrocation (RE) of the feet according to Wegman/Hauschka in addition to an exercise program (EP) as a complementary treatment for CIPN symptoms.

Methods

This study was a prospective, randomized controlled, 2-center trial. A total of 57 patients with CIPN symptoms were randomly allocated into 2 groups, with 52 patients analyzed: the intervention group (n = 26) and the control group (n = 26). While the intervention group received 3 RE according to Wegman/Hauska and EP within 14 days, the control group performed only EP. CIPN symptoms (tingling, numbness, pain and cramps) were evaluated with the Numeric Rating Scale (NRS), and quality of life related to peripheral neuropathy was assessed with the EORTC QLQ-CIPN20 questionnaire.

Results

The mean NRS scores for total CIPN symptoms (tingling, numbness, pain, and cramps) decreased from baseline to 24 hours after the third intervention in both groups. However, the intervention group maintained lower scores 2 weeks later, whereas the scores in the control group returned to baseline levels. A significant time effect was observed for NRS scores with a medium effect size (P < .001, η² = 0.122), but no significant difference was found between the groups (P > .05). Similarly, significant time effects were observed in the sensory and motor subgroups of the EORTC QLQ-CIPN20 (P < .001), although the between-group differences remained nonsignificant (P > .05). While the intervention group showed greater improvements, particularly at 2 weeks post-intervention, a statistically significant difference between the groups was not reached.

Conclusion

According to our study results, RE combined with exercise, particularly after 3 interventions, was more effective in reducing CIPN symptoms in the short-term than was exercise alone; however, symptoms increased again in the absence of interventions (standard care) by the end of the fourth week.