Buerger's Exercises and Proprioceptive Drills on Postural Stability and Foot Perfusion in Elderly Patients With Chemotherapy
Conditions
Keywords
Buerger's Exercises - Proprioceptive Drills - Postural Stability -Foot Perfusion - Elderly Patients - Chemotherapy-Induced Peripheral Neuropathy
Brief summary
Chemotherapy-induced peripheral neuropathy (CIPN) is a common, dose-limiting side effect of neurotoxic chemotherapy agents, characterized by sensory loss, impaired proprioception, and muscle weakness, predominantly affecting the lower limbs. These impairments significantly contribute to postural instability and increase fall risk in elderly patients. Additionally, CIPN-associated microvascular changes can compromise peripheral circulation, further exacerbating neuromotor dysfunction and balance deficits. While pharmacological options for CIPN are limited and often inadequate, exercise-based interventions have shown promise in mitigating functional impairments. Buerger's exercises, a vascular stimulation technique, are known to enhance peripheral blood flow, whereas proprioceptive drills can improve neuromuscular coordination and postural control. However, their combined effect on both postural stability and foot perfusion in elderly patients with CIPN has not been systematically studied.
Detailed description
Aim of the Study To investigate the combined effect of Buerger's exercises and proprioceptive drills on postural stability and foot perfusion in elderly patients with chemotherapy-induced peripheral neuropathy. * Objectives Primary Objectives: * To evaluate the effect of combined Buerger's exercises and proprioceptive drills on postural stability. * To assess their effect on foot perfusion. Secondary Objectives: • To assess changes in balance confidence, functional mobility, and fall incidence. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ * Hypotheses * H1: The combined intervention will significantly improve postural stability compared to standard care. * H2: The combined intervention will significantly enhance foot perfusion compared to standard care.
Interventions
COMBINATION_PRODUCTBuerger's Exercises
Buerger's Exercises + Proprioceptive Drills, 3 times/week for 8 weeks: * Buerger's Exercises: * Leg elevation at 45° for 2 min until blanching * Dependent sitting for 3 min until hyperemia * Supine rest for 5 min * 3 cycles per session * Proprioceptive Drills: * Single-leg stance * Tandem stance/walking * Heel-to-toe walking * Anterior-posterior and lateral weight shifts * Mini-squats on foam * Ankle alphabet * Progressively increased difficulty Sessions supervised by trained physiotherapists.
Sponsors
South Valley University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Aged 65 years or older * Diagnosed with CIPN for at least 3 months * Demonstrating impaired postural stability (BBS ≤ 48 or ≥2 falls in the past year) * Medically cleared for exercise * Cognitively intact (MMSE ≥ 24) * Willing and able to give consent
Exclusion criteria
* Severe peripheral arterial disease (ABI \< 0.5) * Severe postural hypotension or positional syncope * Recent orthopedic procedures or fractures (past 6 months) * Vestibular or cerebellar disorders * Uncontrolled systemic diseases * Cognitive impairment (MMSE \< 24) * Concurrent participation in another structured balance or vascular program * Lower limb ulcers or active infection * Severe visual impairment * Intolerance to positional exercises
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postural Stability Foot Perfusion | Week 8 | .Postural Stability: Overall Stability Index (OSI) via Biodex Balance System SD Foot Perfusion: Laser Doppler Flowmetry (LDF) |
| Pain scale (VAS) Quality of Life Index (QLI) - SCI Version | 8 weeks | Pain scale (VAS) The visual analog scale (VAS) is a validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between "no pain" and "worst pain." Quality of Life Index (QLI) - SCI Version Comprised of 4 domains: 1. Health and functioning 2. Psychological/spiritual 3. Social and economic 4. Family. |
| Weight Height Body mass index | 8 weeks | Weight in kg, height in meter and body mass index in kg/m2 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Secondary Outcomes | 8 weeks | * Berg Balance Scale (BBS) * Timed Up and Go Test (TUG) * Activities-specific Balance Confidence Scale * Number of falls Pain scale (VAS) Quality of Life Index (QLI) - SCI Version Follow-up (Week 8) |
Contacts
CONTACTibrahim abuzaid, Assistant professor
Outcome results
None listed