Touch and manual action in chemotherapy-induced peripheral neuropathy: a mixed-methods study.

Chemotherapy induced peripheral neuropathy (CIPN) is a frequent side effect of a number of chemotherapeutic agents which are widely used in the treatment of common cancers. Sensory symptoms primarily affect the fingers and toes and include numbness, tingling and pain. However, there is limited understanding of how these touch impairments may impact manipulation skills. Questionnaire and focus group methods were used to describe the experience of CIPN side effects impacting manual activities in 25 self-selected participants recruited from a cancer charity web site advertisement. Participants’ responses demonstrated varying degrees of impact of touch impairment associated with CIPN on the performance of manual activities involving bimanual, unimanual and directed touch. Examination of the components of the affected activities, together with participants’ reports of alterations in their experience of touch, were used to generate theory-informed hypotheses about why some manual tasks are more affected than others. In future research it is proposed that quantitative objective measures should be used to complement patient reported outcome measures in evaluating the mechanisms underlying issues in sensory motor control of manual activities caused by the effects of CIPN.