Institution versus Tele-Rehabilitation based balance training program for Chemotherapy Induced Peripheral Neuropathy in Cancer Population

TITLE: Institution versus Tele - Rehabilitation based balance training program for Chemotherapy Induced Peripheral Neuropathy in Cancer Population

**INTRODUCTION:**The National Cancer Institute defines cancer as a disease characterized by the uncontrolled division of abnormal cells, which can invade surrounding tissues and spread to other parts of the body known as metastatic cancer. The burden of cancer can be alleviated through early detection, preventive strategies such as lifestyle modifications, and the use of frontline chemotherapeutic agents.Though patients with chemotherapeutic interventions in combating cancer,  may experience a range of adverse side effects that includes peripheral neuropathy as one of the major effect that negatively impacts one’s own bodily function. A complex interplay of physical, neurological, and sensory impairments leads to imbalance that gives rise to a high risk of fall.

**RATIONALE:**Balance training reduces fall risk by enhancing proprioception, training reactive balance, improving muscle strength and coordination. By incorporating balance training into CIPN management, patients can regain confidence in their mobility, reduce their fall risk, and improve overall functional outcomes.

AIM: To assess the effect of institution versus tele - rehabilitation based balance training program in patients with Chemotherapy induced peripheral neuropathy.

OBJECTIVES:

To assess the effect of institution based balance training program in patients with Chemotherapy induced peripheral neuropathy.

To assess the effect of tele - rehabilitation based balance training program in patients with Chemotherapy induced peripheral neuropathy.

To compare the results obtained in all 2 groups.

**OUTCOME MEASURES:**1. 10m walk test - To assess walking speed in m/s. 2. mini BEST test - to assess balance.

PROTOCOL: The intervention was developed using Horak’s theoretical balance framework which describes 6 interacting systems contributing to balance control : Biomechanical Constraints, Staability Limits, Verticality, Anticipatory Postural Adjustments, Postural Adjustments, Sensory Orientation and Stability in Gait.

Individuals will be asked to rate each of the exercise at the end of the session using a ten-part Likert scale (10 being the greatest level of challenge and 1 being no challenge).

Exercise levels will be tailored to each individual and will be progressed to increase challenge level when perceived challenge to balance is  less than 7.

Initially variable surface conditions and later exercises with eyes closed will be performed.

Frequency - Thrice a week for 4 weeks, Intensity – 10 repetitions/exercise, Duration - 45 minutes, Type – Balance Training.