Using Game-based Exercise to Improve Balance in Cancer Patients

Cancer patients with chemotherapy-induced peripheral neuropathy (CIPN) have deficits in
sensory and motor skills leading to inappropriate proprioceptive feedback, impaired postural
control and high fall risk. This study will investigate the acceptability and effect of an
interactive motor adaptation balance training program based on wearable sensors for improving
balance in older cancer patients with CIPN. Cancer patients with confirmed CIPN will be
recruited and will be randomized to either intervention (IG) or control (CG) group and
followed for 6 months. The intervention group will take part in a 6-week balance training
program twice per week in either their home or in clinic (based on subject preference) under
the supervision of a qualified research staff member. This intervention includes interactive
game-based balance training including repetitive weight shifting and virtual obstacle
crossing tasks. Wearable sensors will provide real-time visual/auditory feedback from foot
and ankle position and allowed perception of motor-errors during each motor-action. The
control group will be instructed to complete a supervised foot and ankle exercise without
using sensor technology. Changes in balance, gait, and physical activity, and number of falls
will be compared pre- and post-intervention, as well as 3 and 6 month post intervention.
Investigators hypothesize that patients receiving sensor-based exercise training will benefit
more compared to group receiving conventional non-technology home-based training in terms of
improving functional performance and reducing falls.