Peripheral neuropathies are a common and clinically relevant group of diseases affecting the peripheral nervous system. The symptoms are often severe, hard to treat, and tend to be long-lasting. These conditions not only lower the quality of life for patients but can also complicate medical treatments and cause further health problems. Currently, there aren’t many proven treatment options. Research on this topic is thankfully increasing. Since the last review in 2014, there has been a significant increase (+25 studies) investigating how exercise might help patients with different causes of polyneuropathy. We therefore aimed to update the review and seek for more potential correlations to generate treatment recommendations.

41 studies matched all our inclusion criteria (neuropathic patients, exercise-only interventions, an inactive or non-exercising control group, and only randomized controlled trials that measured outcomes like neuropathic symptoms, balance, functional mobility, walking, quality of life, and blood sugar levels (HbA1c). 20 had endpoints that could be compared within a meta-analysis. The quality of the studies ranged from moderate to high.

The results showed, that exercise is beneficial for neuropathic patients. This is best documented for patients with diabetic peripheral neuropathy (DPN) (27 studies) and chemotherapy-induced peripheral neuropathy (CIPN) (nine studies). There are only a few studies (five) on other types of neuropathies. We found that the exercise group showed improvements in balance, the Berg Balance Scale, Timed-up-and-go test, nerve conduction velocity, and HbA1c in patients with DPN. For patients with CIPN, balance, quality of life, and neuropathy symptoms improved.

To conclude: For patients with a neuropathy due to diabetes, evidence-based recommendations can now be made, suggesting that a combination of endurance and sensorimotor training is most beneficial For patients with CIPN, sensorimotor training is the most important component.

More high-quality research is needed to make recommendations for other types of neuropathies. Overall, sensorimotor training appears to be very promising for treating most types of neuropathy and combining it with endurance training currently seems to be the best approach.

VICE Study