CanSTEP: Cognitive-motor step training to reduce chemotherapy-induced peripheral neuropathy (CIPN) symptoms in cancer survivors

Chemotherapy-induced peripheral neuropathy (CIPN) is a common and disabling side-effect of treatment for many cancers. Our trial will test whether a four-month rehabilitation program training balance and cognition, commonly impaired in cancer survivors with CIPN, can reduce symptoms and improve balance and quality of life. This intervention has the potential to accelerate access to effective rehabilitation for cancer survivors with CIPN to regain everyday function and live well in remission. 

Participants in this study will be: 
  • Assigned to one of two groups at random (like the flip of a coin): 
    • Intervention group: they will receive the rehabilitation program for four months at home. The training program will involve playing exergames to train their stepping reactions and balance for up to 120 minutes each week. They will also undergo an optional interview to debrief their experience with the program. 
    • Control group: they will continue with their usual activities for 6 months. They will be offered the rehabilitation program at the end of the study.
  • Asked to complete questionnaires on their health and perform tests of balance, walking and cognition. Tests should take approximately 2 hours to complete and will involve two visits to participants’ homes. Questionnaires will be collected on four occasions, taking approximately 45 minutes each time. 
  • Asked to wear a watch that records their daily physical activity levels for a week on three occasions.
To be eligible to participate in this study, you will need to:
  • Be aged 18 years and over; 
  • Be ≥6 months and 5 years after completing neurotoxic chemotherapy treatment for cancer; 
  • Have no scheduled further neurotoxic cancer treatment; 
  • Report chemotherapy-induced peripheral neuropathy symptoms impacting physical function in the lower limbs; 
  • Be able to walk 10 metres without the use of a walking aid;
  • Be willing and able to comply with all study requirements, including treatment, timing and nature of required assessments;
  • Have internet access/​wifi and access to a smart device/​computer.
You will not be able to participate in this study if you have any of the following: 
  • A history of primary brain tumours;
  • A history of metastases (brain or bone) that could affect balance and mobility;
  • Known peripheral neuropathy prior to neurotoxic chemotherapy for cancer;
  • Neurological disorders including stroke, Parkinson’s disease, multiple sclerosis, and dementia;
  • Serious medical or psychiatric condition that might limit your ability to consent to the study and/​or comply with the protocol; 
  • Severe visual impairment. 
  • A medical condition precluding balance and stepping exercise; 
  • Insufficient English language skills to provide informed consent and fully participate in the program.

Funding: Australian National Health and Medical Research Council and World Cancer Research Fund (WCRF UK), as part of the World Cancer Research Fund International grant programme. 

Ethics approval number: 2023/ETH02530


For more information, please email canstep@​neura.​edu.​au.