Rehabilitation in Neuro-Oncology: A Meta-Analysis of Published Data and a Mono-Institutional Experience

Abstract

Background. Rehabilitation for cancer patients with central nervous system (CNS) involvement is rarely considered and data on its use are limited. The purpose of the present study is to collect all available published data on neuro-oncology rehabilitation and perform a meta-analysis where results were presented in a comparable manner. Moreover, the authors report results on cancer patients with neurological disabilities undergoing rehabilitation at their unit. Study design. A PubMed search was performed to identify studies regarding cancer patients with CNS involvement undergoing inpatient physical rehabilitation. Studies with a complete functional evaluation at admission and discharge were selected. As the most common evaluation scales were Functional Independence Measure (FIM) and Barthel Index (BI), only articles with complete FIM and/or BI data were selected for the meta-analysis. Moreover, 23 cancer patients suffering from diverse neurological disabilities underwent standard rehabilitation program between April 2005 and December 2007 at the San Raffaele Pisana Rehabilitation Center. Patient demographics and relevant clinical data were collected. Motricity Index, Trunk Control Test score, and BI were monitored during rehabilitation to assess patient progresses. BI results of patients in this study were included in the meta-analysis. Results. The meta-analysis included results of a total of 994 patients. A statistically significant (P < .05) improvement of both BI and FIM scores was demonstrated after rehabilitation (standardized mean difference = 0.60 and 0.75, respectively). Functional status determined by either FIM or BI improved on average by 36%. Conclusion. Published data demonstrate that patients with brain tumors undergoing inpatient rehabilitation appear to make functional gains in line with those seen in similar patients with nonneoplastic conditions.

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

“…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. 40,42 There is limited evidence to suggest that early physical training, massage therapy, and ambulatory rehabilitation may improve functional outcome, reduce stress, and improve quality of life in patients with glioma.…”

Utilization of rehabilitation services for inpatient with cancer in Taiwan: a descriptive analysis from national health insurance database

“…Rehabilitation or exercise intervention programs at acute medical, surgical oncology, or hospice units have been found to be safe and to enhance physical and psychological functioning among hospitalized cancer patients [11,15-17,19-22]. Cancer patients have been found to benefit as much as non-cancer patients from participating in comprehensive rehabilitation programs [23,24]. In response to these programs, patients, families, and even hospital staff reported improved satisfaction with rehabilitation.…”

Psychiatric symptoms in glioma patients: from&nbsp;diagnosis to management

“…In usual practice, the focus is mostly on the physical recovery of the patient,32 but improvements in neurocognitive functioning are sometimes evaluated as well through brief screening measures such as the functional independence measure (FIM) 33–37. Some evaluation studies show modest improvement in brain tumor patients’ social cognition (assessed with the FIM as social interaction, problem-solving, and memory38), which does not appear to be related to the tumor type 35,36,39.…”