Severe Chemotherapy-Induced Peripheral Neuropathy Presenting with Paraplegic Symptoms: A Rehabilitation Case Report

Authors

• Cecilia Hammond, Midwestern UniversityFollow
• Elizabeth Campione (0009-0009-1212-8582), Midwestern UniversityFollow

Abstract

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is characterized by sensory and/or motor symptoms in distal extremities starting within 24 hours of receiving chemotherapy and can potentially last for years. Management of CIPN may include medication (i.e. Duloxetine) and physical therapy (PT). The purpose of this case report is to describe the rehabilitation process and adjustments to the plan of care for a patient with severe CIPN. This case underscores the importance of a proper diagnosis and the need for research to develop evidence-based guidelines for PT interventions for non-ambulatory patients with severe CIPN.

Case description: The patient was a 53-year-old female in an Inpatient Rehabilitation Facility (IRF) with a primary diagnosis of docetaxel-induced myositis and peripheral sensorimotor axonal polyneuropathy. The patient’s chief complaint was the onset of bilateral lower extremity (BLE) pain and weakness that progressively worsened following the second round of chemotherapy with an inability to walk unassisted. Over six weeks of intensive therapy, the patient went from Maximum Assistance for bed mobility, transfers, and gait to Modified Independent in bed mobility, transfers, and wheelchair mobility.

Outcomes: The Wheelchair Propulsion Test was administered during weeks four and six to quantify efficiency with wheelchair mobility. At discharge, the patient achieved independence in bed mobility, slide board transfers, and wheelchair mobility allowing return to home despite continued decline in BLE strength and function.

Discussion: The patient was admitted to IRF with 5 previous diagnoses, none of which included findings of ongoing demyelination from an electromyography (EMG) completed at a prior emergency department (ED) visit, which impacted the prognosis and delayed development of a proper plan of care (POC). With the lack of evidence-based guidance for non-ambulatory individuals due to severe CIPN, the care team adapted strategies from similar populations with paraplegia. The clinical implications for physical therapists that this case report provides includes increasing awareness of severity types of CIPN, providing exercise and modality options for non-ambulatory patients, and urging research to develop reliable outcome measures and clinical guidelines for patients with severe CIPN.

First Page

46

Last Page

61

DOI

10.26890/oksa3625

Recommended Citation

Hammond C, Campione E. Severe Chemotherapy-Induced Peripheral Neuropathy Presenting with Paraplegic Symptoms: A Rehabilitation Case Report. Oncology Rehabilitation in Practice. 2026; 3(1):46-61. doi: 10.26890/oksa3625.