World Breast Cancer Research Day: How Exercise Improves Gait, Balance, and Quality of Life With Connie Visovsky, PhD, RN, ACNP, FAAN

Research and Career Focus

Dr. Visovsky has dedicated over two decades to understanding the neuromuscular effects of chemotherapy, especially CIPN. “A significant subset of women experience persistent neuropathy affecting nerves and muscles,” she notes, emphasizing impacts on daily function, mood, and quality of life.

Journey Into Breast Cancer Research

Dr. Visovsky’s path was shaped by close work with women during and after treatment. “Hair loss, body image changes, mastectomy, and the fear of recurrence are daily realities,” she explains. She highlights financial toxicity and “scan anxiety,” adding, “Extending life isn’t enough if patients cannot live well.”

CIPN and Falls: An Overlooked Risk

Falls are rarely addressed when prescribing neurotoxic agents such as paclitaxel and docetaxel. “Falls are a major source of disability, injury, and mortality—especially hip fractures in older adults,” she stresses. Her team’s advanced gait analyses reveal granular deficits often missed by routine clinical assessment.

Study Focus and Predictors of Falls

In the National Institute of Health (NIH)–funded Be Happy trial, Dr. Visovsky’s group examined 62 control participants to identify fall predictors without intervention. “The only significant predictors of future falls were recent near falls and reduced ankle plantar flexion,” she says. Notably, “near falls outperformed prior actual falls as a predictor,” underscoring the value of routinely asking about near falls and assessing calf/ankle strength.

Exercise Trial Outcomes

The trial’s 16-week home-based program prescribed gait, balance, and lower-extremity strengthening with bands and bodyweight. “We did not see significant changes in nerve conduction, muscle strength, neuropathy symptoms, or global quality of life,” she reports. However, gait and balance improved markedly in the intervention arm: longer stride length, faster cadence, more single-limb time, and lower gait variability. “Improved balance and gait plausibly reduce fall risk,” she adds.

Exercise Evidence Beyond Breast Cancer

Reflecting on the CHALLENGE trial in colon cancer that was presented at the American Society of Clinical Oncology (ASCO), Dr. Visovsky underscores cross-disease relevance. “Neurotoxic regimens are common, and structured exercise delivers meaningful functional benefits,” she says. “Cancer is a chronic disease; we must pair life-extending therapies with rehabilitation to restore independence.”

Reasons for Optimism on World Breast Cancer Research Day

Dr. Visovsky is encouraged by targeted therapies and the growing emphasis on lifestyle and behavioral interventions. “We’re moving from cure/control alone to comprehensive survivorship—rehabilitation that maximizes function and quality of life,” she concludes.

Key Takeaways

• Screen proactively for near falls; they may predict future falls better than prior falls in women with CIPN.
• Assess and strengthen ankle plantar flexion; simple calf raises can target a modifiable risk.
• Incorporate home-based gait and balance training; expect improvements in stride, cadence, single-limb support, and stability.
• Address BMI and functional status together; higher BMI correlates with poorer balance.
• Embed rehabilitation into survivorship care plans; extending life must be matched with restoring function and independence.

About Dr. Visovsky

Connie Visovsky, PhD, RN, ACNP, FAAN, is a Professor Emeritus who recently retired from being a Professor in the College of Nursing at the University of South Florida, in Tampa, Florida. She has extensive experience as an oncology nurse practitioner and researcher, including investigating the roles of exercise behavior and gait/balance training for improving neuropathy in patients with breast cancer, and global health work in Latin America and Southeast Asia. She has authored numerous peer-reviewed publication focused on nursing management of patients with cancer.