Table 5.

Other outcomes: summary of measures and results

First author (year)	Purpose and intervention	Outcome measures	Main findings
Nathan et al. (2017)[63]	Purpose: Evaluate the effectiveness of community-based mindfulness-based stress reduction (MBSR) courses to improve physical and mental functioning among patients with PDPN whose medical treatment has been optimized. Intervention: Nine sessions of MBSR: eight weekly, 2.5-h sessions and one 6-h session on a weekend day midway through the course. Control: Usual activities, offered the opportunity to enroll in a MBSR course once the study was complete.	Glycosylated hemoglobin (HbA1c) measurement; Patient Health Questionnaire-9 (PHQ-9) for depression; Profile of Mood States-2A (POMS-2A) for total mood disturbance; Perceived Stress Scale (PSS); Pain Catastrophizing Scale (PCS)	Mean PCS score decreased in the MBSR group (− 10.67, 95% CIs [− 14.38 to − 6.95]), between baseline and week 12, compared to the control group (1.69, 95% CIs [− 1.47 to 4.85], p < 0.001). Mean PHQ-9 score significantly reduced in the MBSR group (M = − 4.75, 95% CIs [− 6.55 to − 2.96], p < 0.001), between baseline and week 12, compared to the control group (M = 0.06, 95% CIs [− 1.66 to 1.53], p < 0.001). The MBSR group mean PSS reduced between baseline and week 12 (M = − 4.64, 95% CIs [− 7.89 to − 1.38], p = 0.001), compared to the control group (M = 1.75, 95% CIs [− 0.14 to 3.64], p = 0.001).
Clark et al. (2012)[60]	Purpose: Determine the feasibility of using 3 complementary interventions in relieving the physical and emotional symptoms associated with CIPN while increasing the capacity for mindfulness or self-focused attention. Intervention: D. Reiki intervention (n = 7)—up to 5 sessions over a 6-week period E. Yoga intervention (n = 7)—weekly session over 6 weeks F. Meditation intervention (n = 5)—weekly session over 6 weeks Control: 1 h holistic education weekly for 6 weeks	Psychological distress using the Brief Symptom Inventory (BSI); Mindfulness using the Mindful Awareness Attention Scale (MAAS).	No significant difference between groups on BSI and MAAS
Ahn and Song (2012)[67]	Purpose: Determine the effects of tai chi exercise on glucose control, neuropathy scores, balance, and quality of life in patients with diabetic PN. Intervention: Standardized tai chi for diabetes of 1 h of tai chi per session, twice a week for 12 weeks. Control: Usual care	Fasting blood sugar (FBS); HbA1c; Semmes–Weinstein 10-g monofilament examination scores (SWME); single leg stance for balance.	Mean FBS reduced in the intervention group (M = 137.85 mg/dL, SD = 45.19 to 125.5 mg/dL, SD = 45.57, p = 0.036) compared to the control group (M = 143.47 mg/dL, SD = 47.45 to 155.31 mg/dL, SD = 44.88, p = 0.036). A significant difference was seen in HbA1c levels post-intervention in the tai chi group (M = 7.20, SD = 1.32, p = 0.004) compared to the control group (M = 8.32, SD = 1.76, p = 0.004). Differences in pre- and post-test balance mean scores indicated significant improvement in balance for the tai chi group (M = − 7.65, SD = 16.78, p = 0.044), compared to the control group (M = 1.44, SD = 9.97, p = 0.044). The SWME identified no significant changes in peripheral sensory function pre- and post-test.
Kluding et al. (2012)[64]	Purpose: Examine the feasibility of a supervised, moderately intense aerobic and resistance exercise program in people with diagnosed diabetic PN. Intervention: 10-week exercise program with both aerobic and strengthening elements, 3 to 4 times per week. Control: None	BMI; Resting heart rate (RHR) Glycosylated hemoglobin (HbA1c); Michigan Neuropathy Screening Instrument (MNSI) physical exam score; Nerve conduction studies (NCS); Quantitative Sensory Testing (QST); intraepidermal nerve fiber density (IENF)	Significant reduction in HbA1c (M = 7.8, SD = 1.0 pre-intervention to M = 7.28, SD = 0.83 post-intervention, p = 0.031). Significant increase in IENF branching at the proximal biopsy site (M = 0.16, SD = 0.15 pre-intervention to M = 0.27, SD = 0.19 post-intervention, p = 0.008). Significant reduction in RHR (M = 77.3, SD = 8.2 pre-intervention to M = 72, SD = 9.6 post-intervention, p = 0.036). No significant difference in NCS or QST
Ruhland and Shields (1997)[65]	Purpose: Examine the effects of a home exercise program on PN impairment and quality of life. Intervention: Exercise with Thera-Bands and cycling or walking for 10 to 20 min, over 6 weeks. Control: Maintain current levels of activity	Average Muscle Score (AMS); handgrip force; forced vital capacity (FVC); timed 9.1 m walk	Significant improvement in mean AMS in exercise group (pre-test M = 8.8, post-test M = 9.2, p = 0.002); significant improvement in handgrip force (pre-test M = 28.6, post-test M = 30.8, p = 0.033)
Yoo et al. (2015)[61]	Purpose: Explore the effect of a supervised, moderate-intensity aerobic exercise training intervention on pain and pain interference in daily life, specifically in people with DPN. Intervention: 16 weeks of supervised aerobic exercise 3 times a week, of 30 to 50 min duration. Control: None	Objective: body mass index (BMI); aerobic fitness (VO2max); blood pressure; glycemic control (hemoglobin A1c)	No significant changes were found for BMI, blood pressure, or glycemic control. Significant improvement in mean maximum oxygen uptake (VO2max) (mL/kg/min) (M = 16.02, SD = 3.84 pre to M = 17.18, SD = 4.19 post, p = 0.028).
Gewandter et al. (2018)[72]	Purpose: To inform a future randomized phase 2 study and determine if TENS has the potential to improve CIPN. Intervention: Wireless TENS therapy for at least 1 h twice per day for a 6-week period. Control: None	Objective: Utah Early Neuropathy Score (UENS); forced choice monofilament test	No significant improvements with UENS; monofilament test reported sensation threshold improved in 10 of 16 (63%; 95% CI [35–85%], p < 0.0001) participants who completed the test.
Serry et al. (2015)[71]	Purpose: To investigate the efficacy of TENS versus aerobic exercise, and to compare them with regular pharmacological therapy in patients with diabetic PN. Group A: Received TENS therapy for 30 min 3 times per week for 8 weeks in addition to regular pharmacological therapy for PN. Group B: Engaged in aerobic exercise for 30 min 3 times for week for 8 weeks in addition to regular pharmacological therapy for PN. Group C: Received only regular pharmacological therapy for PN and oral hypoglycemic drugs or insulin.	Nerve conduction studies (NCS) to measure medial plantar sensory nerve conduction velocity (SCV)	No significant differences in SCV between pre- and post-test measurements for any of the groups, or between the groups
McCrary et al. (2019)[68]	Purpose: Evaluate the impact of a multimodal exercise intervention on CIPN symptoms, functional deficits and neurophysiologic parameters. Intervention: 8-week exercise intervention with resistance, balance, and cardio elements, 3 times per week. Control: 8 week pre-intervention control period	Objective: Total Neuropathy Score Clinical version (TNSc); mobility (6 min timed walk); standing balance (Swaymeter); lower limb strength and dynamic balance (5 times sit to stand test)	Significant reduction in TNSc symptom score (M = 7.0, SE = 0.7 pre-exercise to M = 5.3, SE = 0.5 post-exercise, p = 0.001); significant increase in distance in 6 min walk test (m) (M = 452.1, SE = 17.4 pre-exercise to M = 469.9, SE = 20.9 post-exercise, p = 0.02); significant reduction in 5 times sit to stand time (s) (M = 13.1, SE = 0.8 pre-exercise to M = 11.8, SE = 0.6 post-exercise, p = 0.03); significant reduction in postural sway (mm) on a stable surface eyes open (M = 140.9, SE = 23.6 pre-exercise to M = 104.2, SE = 13.6 post-exercise, p = 0.006)

PDPN = painful diabetic peripheral neuropathy; CI = confidence interval; M = mean; mg = milligram; dL = deciliter; SD = standard deviation; PN = peripheral neuropathy; kg = kilogram; min = minute; DPN = diabetic peripheral neuropathy; TENS = transcutaneous electrical nervous stimulation; CIPN = chemotherapy-induced peripheral neuropathy; SE = standard error