Table 1.

Summary of included studies investigating the effects of an exercise intervention on CIPN. Abbreviations: CG, Control Group; IG, Intervention Group.

Study	Participants	Study Design	Exercise Protocol	CIPN measures	Outcomes
Henke et al., 2014	Lung cancer patients, ongoing chemotherapy (N = 46) IG: N = 25, CG: N = 21	Randomized controlled trial (RCT), outcomes measured at baseline and after 3 cycles of chemotherapy	Type: supervised hallway/stair walking and resistance training Frequency: 5 days/week & every other day (total duration of treatment) Intensity: 55–70% of heart rate reserve (HRR) for walking and 50% of maximum repetitions (RM) for strength Time: 6-minute hallway walk, 2-minute stair walk, strength sessions based on repetitions	Objective: none Subjective: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTQLQ C-30) with peripheral neuropathy sub-scale	Significant difference between groups in subscale of peripheral neuropathy (p = 0.05)
Kleckner et al. (2018)	Non-leukemia cancer without metastases, chemo-naïve, starting chemo (N = 355) IG: N = 170 CG: N = 185	RCT, outcomes measured at baseline and after 6 weeks	Type: ACSM Exercise for Cancer Patients (EXCAP): Home-based walking + resistance bands Frequency: daily Intensity: low-to-moderate Walking: 60–85% of HRR Bands: Rated perceived exertion (RPE) of 3–5 (1–10 scale) Time: individually tailored, progressive prescription based on baseline ability	Objective: none Subjective: symptoms of numbness and tingling, hot/coldness in hands/feet (0–10 scales)	Exercise associated with smaller pre- to post-intervention increases in CIPN severity. Numbness/tingling increased by 0.58 and hot/coldness increased by 0.77 in the CG while numbness/tingling increased by 0.38 and hot/coldness increased by 0.38 in the IG (p = 0.061 and p = 0.045)
McCrary et al. (2019)	Cancer survivors ($\ge$ 3 months post-treatment with neurotoxic chemotherapies) with established CIPN symptoms. N = 29	Single-group pre-post design, outcomes measured at 3 timepoints: before 8-week control period (T0), after control period but before exercise intervention (T1), and after 8-week exercise intervention (T3)	Type: Individualized prescription of aerobic, resistance, and balance training sessions (half supervised, half done at home) Frequency: 3 sessions/week (total of 8 weeks) Intensity: all exercises performed at RPE of 13–15 (6–20 scale) Time: 1 h per session	Objective: Total Neuropathy Score- clinical version (TNSc; assessment of muscle weakness, numbness/tingling, pinprick, vibration, tendon reflex, and strength, scored 0–24), nerve conduction studies Subjective: EORTC CIPN-20 (patient-reported questionnaire of CIPN symptoms, scored 0–100)	Exercise improved clinically-assessed (TNSc baseline: 6.7, pre-exercise: 7.0, post-exercise: 5.3, p < 0.01) and patient-reported (CIPN-20 baseline: 26.6, pre-exercise: 25.4, post-exercise: 18.2, p < 0.01) symptoms of CIPN after no such improvement was found during the control period. Exercise did not significantly change sensory or motor nerve amplitudes, refractoriness, or excitability
Streckmann et al. (2014)	Lymphoma patients undergoing chemotherapy (N = 61) IG: N = 30 CG: N = 31	RCT, outcomes measured at 4 timepoints: prior to chemotherapy (T0), after 12 weeks (T1), after 24 weeks (T2), and after 36 weeks (T3)	Type: supervised aerobic (treadmill or bike-dynamometer), sensorimotor (4 postural stabilization tasks), and resistance (4 exercises) Frequency: 2 sessions/week (total of 36 weeks) Intensity: Aerobic: 70–80% HRmax Sensorimotor: progressively increasing task difficulty Strength: exercises carried out at maximum force Time: 1-hour sessions, each consisting of: Aerobic: 10–30 min Sensorimotor: three 20-second sets for each exercise	Objective: PNP-related deep sensitivity evaluated by tuning fork (0–8 scale), balance control on static and dynamic surfaces Subjective: EORTC QLQ-30 (quality of life questionnaire)	PNP-related deep sensitivity declined in 7/8 (87.5%) of intervention group, compared to 0/12 (0%) in control group (p < 0.001) IG showed greater improvements in static (p = 0.03) and dynamic (p = 0.007) balance control than CG, which showed steady decline IG reported significantly better QOL at 12 weeks compared CG (p = 0.03), though no difference between groups was seen at 36 weeks
Zimmer et al. (2018)	Stage IV colorectal cancer patients, life expectancy $\ge$ 6 months, undergoing palliative chemotherapy (N = 30) IG: N = 17 CG: N = 13	RCT, outcomes measured at 3 timepoints: baseline (T0), after 8-week intervention (T1), and 4 weeks post-intervention (T2)	Type: Supervised aerobic (walking, bicycle ergometer, or cross-trainer), resistance (circuit training of bench press, lat pulldown, leg press, seated row, and abdominal exercise), and balance Frequency: 2 sessions/week (total of 8 weeks) Intensity: Aerobic: 60–70% HRmax Resistance: 60–80% of hypothetical 1RM Time: 60-minute sessions	Objective: balance, hypothetical 1RM, endurance capacity (6MWT) Subjective: Trial Outcome Index (TOI) of the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group Neurotoxicity (FAACT/GOG-NTX) questionnaire (4-point change signifies clinical significance)	Overall TOI remained stable for IG from T0 to T1 and from T0 to T2, but worsened for CG from T0 to T1 (-7.1 points, p = 0.028) and from T0 to T2 (-8.1 points, p = 0.037). Across the 8-week intervention, neuropathic symptoms significantly improved in IG (+2.12 points on NTX subscale, p = 0.023), while worsening in CG (-5.11 points, p = 0.45). Change in severity of neuropathic symptoms was significantly different between IG and CG from T0 to T1 (p = 0.002) and from T0 to T2 (p = 0.015).