Aims
To determine whether exercise improves symptom severity, pain and quality of life in adults with chemotherapy-induced peripheral neuropathy (CIPN), and to provide evidence-based exercise recommendations for supportive care.
Methods
SPORTDiscus, MEDLINE and CINAHL were searched from inception to December 2025 for randomised controlled trials assessing the effects of exercise on symptom severity, pain and quality of life in adults with CIPN. Data extraction and quality assessment were performed. Meta-analyses were conducted for each outcome, with assessment of heterogeneity and publication bias.
Results
Nine studies (n = 413) were included in the review. Interventions included multimodal (n = 5), resistance (n = 1), yoga (n = 2), sensorimotor (n = 1) and whole-body vibration (n = 1). Multimodal, resistance, sensorimotor, whole-body vibration and hand and foot specific exercises showed improvements in outcomes. Six studies were judged to have a low risk of bias. Eight studies were included in meta-analyses, which showed a moderate but non-significant improvement in symptom severity (Hedges’ g = 0.53, p = 0.156), moderate and statistically significant reduction in pain (Hedges’ g = 0.69, p = 0.018) and large and statistically significant improvement in quality of life (Hedges’ g = 0.97, p = 0.002). Substantial to considerable heterogeneity was observed across outcomes. No evidence of publication bias was detected.
Conclusions
Exercise shows promise for reducing the burden of CIPN, particularly multimodal, resistance, sensorimotor, whole-body vibration and hand and foot specific exercises. Further research is needed to establish the most appropriate exercise prescription to inform future exercise guidelines.