Case Report


Physiotherapy management of chemotherapy induced peripheral neuropathy in a gynecological condition through clinical reasoning process: A case study

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1 MScPT (Part-II), Clinical Physiotherapist, Centre for the Rehabilitation of the Paralysed (CRP), Dhaka, Savar, Bangladesh

2 2MScPT, Associate professor & Head of Physiotherapy Department, Centre for the Rehabilitation of the Paralysed (CRP), Dhaka, Savar, Bangladesh

3 MSc in Neuroscience, Department of Physiotherapy, Bangladesh Health Professions’ Institute (BHPI), Dhaka, Savar, Bangladesh

4 MScPT, Assistant, Professor, Department of Physiotherapy, Bangladesh Health Professions’ Institute (BHPI), Dhaka, Savar, Bangladesh

5 MBBS, DGO, Consultant in Gynecology & Obstetrics, Ibn Sina Diagnostic Centre, Dhaka, Savar, Bangladesh

6 MPH, Junior Consultant & In-charge of Physiotherapy Department, Centre for the Rehabilitation of the Paralysed (CRP), Mirpur centre, Plot A/5, Mirpur – 14, Dhaka, Bangladesh

7 BScPT, Gynecological & Women’s Health Physiotherapist, Centre for the Rehabilitation of the Paralysed (CRP), Mirpur centre, Plot A/5, Mirpur – 14, Dhaka, Bangladesh

Address correspondence to:

K. M. Amran Hossain

Centre for the Rehabilitation of the Paralysed (CRP), Chapain, Savar, Dhaka 1343,

Bangladesh

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Article ID: 100045D05KH2018

doi: 10.5348/100045D05KH2018CR

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How to cite this article

Hossain KMA, Hossain MA, Mamin FA, Rahman E, Afroz N, Sonia NJ, Khan SA. Physiotherapy management of chemotherapy induced peripheral neuropathy in a gynecological condition through clinical reasoning process: A case study. Edorium J Disabil Rehabil 2018;4:100045D05KH2018.

ABSTRACT


Introduction: Gynecological cancer survivors completing chemotherapy has a diverse presentation of pain, neurological disturbances and functional impairments that constitutes several impairments in ICF framework that hinders optimum quality of life. The study intended to determine the impact of Physiotherapy interventions through clinical reasoning procedure by international classification of functioning, disability and health (ICF).

Case Report: The case was a uterine carcinoma case completing surgery & chemotherapy and seeks Physiotherapy complaining lower back pain, numbness & decreased strength in both lower limbs with functional and psycho-social impairments. The patient has been managed in three tract reasoning & Hypothetco deductive reasoning process of clinical reasoning. The Interventions focused on strengthening exercise of lower limbs, pelvic floor exercise, aerobic exercise and exercise to improve balance. After two weeks, Mckenzie extension approach for lumbar spine and neural sliding of lower limbs has been added as adjacent therapy. Treatment has been provided for eight sessions in four weeks and continued home exercises for another four weeks. Outcome has been measured and found positive effects on in pain redaction, remission of numbness, improvement of balance, strength of lower limb and quality of life measure.Single session follow up after three months from screening revealed sustainability of improvements that reflects efficacy of physiotherapy interventions in diverse indicator in ICF framework.

Conclusion: Chemotherapy induced musculoskeletal complications are certainly manageable through physiotherapy interventions and McKenzie extension approach found effective to remission of lumber radicular symptoms in CIPN. The interventions have positive effect in longer run and upon quality of life in gynecological cancer survivors.

Keywords: CIPN, Gynecology, ICF, Physiotherapy

SUPPORTING INFORMATION


Author Contributions:

K. M. Amran Hossain - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Mohammad Anwar Hossain - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published

Feroz Ahmed Mamin - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Ehsanur Rahman - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Nasrin Afroz - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published

Nusrat Jahan Sonia - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published

Shati Aziz Khan - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published

Guaranter of Submission

The corresponding author is the guarantor of submission.

Source Of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this case report.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2018 K. M. Amran Hossain et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.


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