Changing Paradigms in the Rehabilitation of Inpatients with Brain Tumors

Abstract

Neurologic tumors account for over 50% of American acute inpatient rehabilitation facility cancer admissions. WHO Grade IV astrocytoma (also known as glioblastoma multiforme, high grade glioma or GBM) is the most common primary brain tumor in adults and is invariably fatal. The majority of primary brain tumor patients experience neurologic deficits. However, under-referral from oncology to rehabilitation has been reported. This brief narrative review article covers functional, medical and regulatory considerations when rehabilitating brain tumor inpatients.

Can Multidisciplinary Inpatient and Outpatient Rehabilitation Provide Sufficient Prevention of Disability in Patients with a Brain Tumor?—A Case-Series Report of Two Programs and A Prospective, Observational Clinical Trial

“…The most common histological type of primary CNS cancer is glioma as a group of malignant brain tumors (BT), including high-grade glioma or glioblastoma and low-grade gliomas (astrocytoma, oligodendroglioma), and other tumors of glial origin (ependymomas, schwannomas), medulloblastomas, CNS lymphomas, and meningiomas [2,3]. Due to clinical and technological advancements in oncological therapy, the survival rate of patients with primary BT has significantly increased in recent years [1,4], generating a growing need for rehabilitation treatment to diminish neurological impairments and restore their quality of life (QoL) [5,6]. Disability in this group of cancer patients may be due to the dysfunction of the CNS, depending on the location and size of the removed tumor, the method of oncological treatment (surgery, chemotherapy, radiotherapy), and the following cancer therapy [3,6].…”

“…Disability in this group of cancer patients may be due to the dysfunction of the CNS, depending on the location and size of the removed tumor, the method of oncological treatment (surgery, chemotherapy, radiotherapy), and the following cancer therapy [3,6]. Thus, patients with BT and their families need to be aware of the consequences of disability effects caused by the tumor itself or the side effects of oncological treatment [5]. BT patients present significant functional and psychosocial impairments that limit their participation in daily activities.…”

“…Many of those are connected with neurological deficits, leading to behavioral, cognitive, and physical dysfunctions [3]. In addition, BTs and their onco-therapy can have a negative impact on patients' QoL including their family life, work, and self-sufficiency, which is associated with significant costs and socioeconomic implications like increased requirements for health care, and social care services [5][6][7][8]. As these difficulties have complex manifestations, multidisciplinary expertise is necessary to evaluate the influence of each variable in the rehabilitation plan in order to provide appropriate support.…”

“…As these difficulties have complex manifestations, multidisciplinary expertise is necessary to evaluate the influence of each variable in the rehabilitation plan in order to provide appropriate support. Contemporary evidence for the effectiveness of rehabilitation treatment is favorable in many cancer patients [5,9]. Despite the high probability of clinical complications that result in disabilities, dysfunction, or neurological symptoms, functional and cognitive rehabilitation following cancer treatment in BT patients is still fairly uncommon [5,9].…”

Evaluation of Everyday Activities in Patients after Brain Tumor Surgery

“…Its assessment is currently the basic component of the overall assessment of the patient [3]. It is necessary for the proper selection of diagnostic, prophylactic, therapeutic, rehabilitation, nursing, social and psychological activities [4].…”