Effects of Exercise Interventions on Chemotherapy-Induced Peripheral Neuropathy-Related Pain in Patients With Cancer: A Systematic Review and Network Meta-analysis.

Background: Chemotherapy-induced peripheral neuropathy (CIPN)-related pain seriously affects patients' quality of life (QoL). Previous studies have shown that exercise interventions can improve symptoms such as pain in patients with CIPN. However, the optimal exercise intervention remains unknown.

Objective: To explore the comparative effects and ranks of all exercise-based interventions in improving CIPN-related pain, CIPN symptoms, and QoL in cancer patients experiencing CIPN.

Methods: We searched 10 electronic databases to identify randomized controlled trials from their inception up to June 23, 2024. We used Review Manager 5.4.1 and Stata v14.0 for traditional meta-analysis and network meta-analysis (NMA).

Results: This review included 14 randomized controlled trials with a total of 1127 participants. The NMA revealed that: (a) a combination of strengthening, stretching, and balance exercises (standardized mean difference [SMD] = -11.43, 95% confidence interval [CI], -13.60 to -9.26) was the most effective intervention for improving CIPN-related pain; (b) walking exercise (SMD = -2.07, 95% CI, -2.70 to -1.43) yielded better outcomes in alleviating CIPN symptoms; and (c) interventions focused on muscle strengthening and balancing exercises (SMD = 1.03, 95% CI, 0.40 to 1.65) were most effective for improving QoL.

Conclusions: Our NMA indicated that strengthening, stretching, and balance exercises could potentially benefit the improvement of CIPN-related pain. Further evidence is needed.

Implications for practice: This study provides evidence about the effectiveness of exercise interventions for CIPN-related pain. Future research on pain management in subgroups of CIPN patients may benefit from exploring the exercise strategies identified in this study, providing important support to healthcare professionals.