Early rehabilitation after surgery improves functional outcome in inpatients with brain tumours

Abstract

Clinical experience suggests that application of the fundamental principles of rehabilitation medicine can improve the care of patients with cancer. Despite the high incidence of neurological and functional deficits in patients affected by brain tumours (BTs), rehabilitation treatment of this population is not as well established as it is for patients with other neurological conditions. To assess functional outcome in brain tumour inpatients who underwent early rehabilitation after surgery. 75 patients who had undergone neurosurgery for primary BTs and 75 patients affected by stroke were enrolled in a case-control study. All patients were evaluated by means of a core set of clinical scales (Functional Independence Measure, Sitting Balance score, Standing Balance score, Hauser Index, Massachusetts General Hospital Functional Ambulation Classification). Patients were evaluated before the beginning (T0) and at the end (T1) of rehabilitation treatment. The neurorehabilitation programme consisted of individual 60-min sessions of treatment, administered once a day, six days a week, for four consecutive weeks. Speech therapy was included when aphasia was diagnosed. All the measures of outcome were indicative of substantial improvements for neuro-oncological and for stroke patients (P = 0.000). Analysis of subgroups showed that patients affected by meningioma achieved better results (in efficiency terms) as regards independence in activities of daily living (P = 0.02) and mobility (P = 0.04) compared with patients affected by glioblastoma or stroke. Rehabilitation after surgery can improve functional outcome, justifying the delivery of rehabilitation services, even during the acute phase, to BTs inpatients, irrespective of tumour type.

Supportive Care Needs following Cancer Treatment: A Comparison of Breast and Brain Cancer in an Australian Cohort

“…The BT and BC survivors in this study are similar to those in other studies in terms of age, gender, disease severity, and treatment [10,[34][35][36][37][38]. The median time since diagnosis was just over 2 years with established impairments and functional disability.…”

European Association for Neuro-Oncology (EANO) guidelines for palliative care in adults with glioma

“…stroke or traumatic brain injury. 40,42 A review of 11 retrospective studies suggests a mean 36% improvement in functional independence, with a median length of inpatient stay of 1.5 months. 43 Matched case control studies suggest similar functional improvements to those seen post stroke and head injury.…”

Contribution to hand functional assessment based on its kinematics

“…Many studies have examined the evolution of the ability to perform ADL in patients under clinical or rehabilitation treatments Chemerinski et al 2001;Bartolo et al 2012). Movement skills such as grasp and manipulation seem to be directly related with the capability to perform ADL.…”