Chemotherapy-induced peripheral neuropathy in oncology rehabilitation: knowledge, diagnostic approaches, and practical experience of physical therapists

Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common and clinically significant adverse effects of anticancer therapy, particularly associated with neurotoxic agents such as taxanes, platinum compounds, vinca alkaloids, and proteasome inhibitors. CIPN manifests as sensory, motor, and autonomic dysfunctions, including pain, paresthesia, balance impairment, muscle weakness, and functional limitations. These symptoms persist after the completion of cancer treatment, leading to reduced quality of life, limitations in daily activities, and an increased risk of falls and long-term disability. With the global rise in cancer incidence and improved survival rates, CIPN has become a major survivorship issue and an increasing challenge for healthcare systems. Oncology rehabilitation, particularly physical therapy, plays a crucial role in addressing functional impairments associated with CIPN. Evidence-based physical therapy interventions can improve balance, strength, mobility, and functional independence. However, the effectiveness of rehabilitation depends on the level of professional awareness, the use of standardized and validated assessment tools, and the integration of rehabilitation services into multidisciplinary oncology care. In Ukraine, data on the preparedness of physical therapists to manage CIPN remain limited, underscoring the relevance of this study. Purpose. The aim of the study was to assess the level of awareness and knowledge of physical therapists and rehabilitation team members regarding chemotherapy-induced peripheral neuropathy, to identify key barriers to effective clinical practice, and to evaluate readiness for continuing professional development in the field of oncology rehabilitation in Ukraine. Materials and methods. A voluntary, anonymous, cross-sectional online survey was conducted using the Google Forms platform. The study included 103 physical therapists and rehabilitation professionals working in various healthcare settings. The questionnaire consisted of 32 structured items grouped into four domains: sociodemographic characteristics; professional education and clinical experience; knowledge of CIPN pathophysiology, clinical manifestations, and neurotoxic chemotherapy agents; and familiarity with assessment tools and physical therapy interventions used in CIPN management. Data were analyzed using descriptive statistics and presented as frequencies and percentages. Results. The results revealed substantial variability in professional awareness of CIPN. Only 28.9% of respondents reported being fully familiar with the condition, while nearly one-third demonstrated insufficient or minimal knowledge of CIPN-related mechanisms and symptoms. The use of validated assessment tools was limited, with many participants unfamiliar with recommended instruments such as the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire – CIPN20, and the Common Terminology Criteria for Adverse Events. In clinical practice, therapeutic exercises and proprioceptive or balance training were the most frequently applied physical therapy interventions. However, 42.2% of respondents reported not using any specific physical therapy approaches for patients with CIPN. The main barriers to effective management included insufficient theoretical and practical knowledge, lack of standardized clinical protocols, limited access to specialized educational resources, and weak interdisciplinary collaboration within oncology care teams. Conclusions. The study demonstrates a moderate-to-low level of awareness and preparedness among physical therapists in Ukraine regarding chemotherapy-induced peripheral neuropathy, accompanied by significant gaps in assessment and intervention practices. At the same time, a high level of motivation for continuing education was identified, representing an important opportunity for advancing oncology rehabilitation. Targeted educational programs, wider implementation of evidence-based assessment tools, standardized clinical guidelines, and strengthened interdisciplinary collaboration may improve physical therapy services and enhance functional outcomes and quality of life for cancer survivors affected by CIPN.