Rehabilitation of Adult Patients with Primary Brain Tumors: A Narrative Review

Thakkar, Parth; Greenwald, Brian D.; Patel, Palak

doi:10.3390/brainsci10080492

Cited by 28 publications

(20 citation statements)

References 74 publications

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“…There is vast literature on neurological and oncological rehabilitation but relatively little on the rehabilitation of patients with brain tumors [ 24 , 34 ], although several randomized controlled trials are now underway to address this knowledge gap [ 35 , 36 , 37 ]. The functional status and condition of patients with brain tumors are often compared with those occurring in patients after stroke [ 34 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ] or craniocerebral injury [ 42 , 46 , 47 ]. Only a few studies have examined patients with tumor recurrence as a distinct group, usually evaluating reoperation outcomes with respect to overall survival and progression-free survival [ 48 , 49 , 50 ] or quality of life [ 22 ] and not usually in terms of rehabilitation outcomes.…”

Section: Discussionmentioning

confidence: 99%

Rehabilitation Outcomes for Patients with Motor Deficits after Initial and Repeat Brain Tumor Surgery

Krajewski

Furtak²,

Zawadka‐Kunikowska

et al. 2022

IJERPH

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Repeat surgery is often required to treat brain tumor recurrences. Here, we compared the functional state and rehabilitation of patients undergoing initial and repeat surgery for brain tumors to establish their individual risks that might impact management. In total, 835 patients underwent operations, and 139 (16.6%) required rehabilitation during the inpatient stay. The Karnofsky performance status, Barthel index, and the modified Rankin scale were used to assess functional status, and the gait index was used to assess gait efficiency. Motor skills, postoperative complications, and length of hospital stay were recorded. Patients were classified into two groups: first surgery (n = 103) and repeat surgery (n = 30). Eighteen percent of patients required reoperations, and these patients required prolonged postoperative rehabilitation as often as those operated on for the first time. Rehabilitation was more often complicated in the repeat surgery group (p = 0.047), and the complications were more severe and persistent. Reoperated patients had significantly worse motor function and independence in activities of daily living before surgery and at discharge, but the deterioration after surgery affected patients in the first surgery group to a greater extent according to all metrics (p < 0.001). The length of hospital stay was similar in both groups. These results will be useful for tailoring postoperative rehabilitation during a hospital stay on the neurosurgical ward as well as planning discharge requirements after leaving the hospital.

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Section: Discussionmentioning

confidence: 99%

Rehabilitation Outcomes for Patients with Motor Deficits after Initial and Repeat Brain Tumor Surgery

Krajewski

Furtak²,

Zawadka‐Kunikowska

et al. 2022

IJERPH

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“…U pacjentów z guzami mózgu częściej niż w przebiegu innych chorób nowotworowych (Lidstone et al, 2003) obserwuje się również zmiany neurobehawioralne o bardzo zróżnicowanym obrazie. Pojawiają się deficyty poznawcze i wykonawcze (Dwan et al, 2015), zaburzenia nastroju (Arnold et al, 2008), a także objawy psychotyczne, zmiany w zachowaniu i w osobowości (Lezak et al, 2004;Thakkar et al, 2020). Ponadto chorzy doświadczają stresu i zmęczenia (Pelletier et al, 2002), które są bezpośrednimi konsekwencjami obecności guza mózgu, wiążą się z zaburzeniami poznawczymi i zaburzeniami nastroju albo stanowią efekt uboczny leczenia (Valentine i Meyers, 2001).…”

Section: Guzy Mózguunclassified

“…Ponadto chorzy doświadczają stresu i zmęczenia (Pelletier et al, 2002), które są bezpośrednimi konsekwencjami obecności guza mózgu, wiążą się z zaburzeniami poznawczymi i zaburzeniami nastroju albo stanowią efekt uboczny leczenia (Valentine i Meyers, 2001). Jak już wspomniano, leczenie guzów wenątrzczaszkowych, obejmujące interwencje neurochirurgiczne, radioterapię i chemioterapię, obarczone jest dodatkowo występowaniem efektów jatrogennych (zaburzenia nastroju, deficyty poznawcze i wykonawcze, postępujące otępienie podkorowe, encefalopatia) (Thakkar et al, 2020), które są źródłem zakłóceń emocjonalnych, dyskomfortu i trudności w szeroko rozumianym funkcjonowaniu społecznym. Liczba dotychczasowych badań nad oddziaływaniami psychoterapeutycznymi w grupie chorych z guzami mózgu jest niewielka.…”

Section: Guzy Mózguunclassified

Could neurosurgical patients benefit from psychotherapy? A few words on the use of cognitive-behavioural therapy in brain injured patients

Pawełczyk¹,

Błaszczyk²,

Pawełczyk³

et al. 2020

Aktualn Neurol

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Numerous studies have shown the effectiveness of cognitive-behavioural therapy in the treatment of various mental disorders. The present study reviews the available literature on the use and effectiveness of this therapy, both its classic form and more recent approaches (the so called “third wave”), among patients with brain injuries and those treated with surgical methods. We present a number of studies describing the use of cognitive-behavioural therapy in the treatment of patients with craniocerebral injuries, brain tumours, intracranial bleeding and vascular malformations. The obtained results are promising for the treatment of depression and anxiety disorders, post-traumatic stress disorder as well as sleep disorders, impulsivity and aggressive behaviour. The findings suggest that cognitive-behavioural therapy techniques may be effective in both these groups of patients and their families or caregivers. Currently, due to the small number of randomised controlled trials, high heterogeneity of study groups and a variety of research protocols, these findings do not allow for drawing final conclusions and proposing recommendations. Nevertheless, they demonstrate that the strategy offers promise when treating patients with brain damage. It is suggested that psychotherapy should be initiated after the end of the acute phase of the disease as it requires a certain level of self-awareness and an ability to test hypotheses, so it may be inadequate for patients with profound cognitive impairment. It requires the cooperation of a multidisciplinary team: doctors, physiotherapist, neuropsychologist and psychotherapist who, in addition to therapeutic skills, should have knowledge of the brain–behaviour relationship.

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“…The psychological impact of brain tumour caregiving is particularly high and well documented (Auon et al, 2015Chen et al, 2021Halkett et al, 2017;Philip et al, 2020;Reinert et al, 2020). A primary brain tumour (BT), whether benign or malignant, glioma or otherwise, can be a source of significant morbidity and disability (Cahill & Armstrong, 2011), while gliomas-the most common BTs (Riblet et al, 2014)-are often malignant and associated with high mortality rates (Thakkar et al, 2020). Regardless of type, the unique progression of physical, cognitive, behavioural, emotional, and generalised cancer symptoms associated with a BT and its treatment presents a significantly higher, and more complex, caregiving workload than most other cancers (Aoun et al, 2015;Khan et al, 2014), ultimately reducing caregivers' quality of life (Boele et al, 2013;Sherwood et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

“You need someone steering the ship for you”: Australian brain tumour care coordination needs, practices, and opportunities.

Cootes

Heinsch

Wells

et al. 2022

Preprint

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Objective In Australia, care coordination has not been widely adopted in neuro-oncology services and there is a dearth of empirical evidence about routine care coordinator practices with brain tumour (BT) patients and their caregivers. In this study, we explored how neuro-oncology service models can best promote personalised, flexible interventions, and how BT care coordination can be effectively integrated within Australian health care services. Methods We used a qualitative approach, conducting semi-structured interviews with 21 informal brain tumour caregivers and 11 multidisciplinary health and social care professionals. Results Three main themes were developed: i) “No-one’s really on your team”: Need for patient-and family-centred care, partnership, and support; ii) “You need someone steering the ship for you”: Navigating complexity and guiding the whole family; and iii) “Good, shared decision-making communication improves patient outcomes every time”: Future opportunities and modifiable factors. Conclusion Care coordination can improve the responsiveness of BT care and increase the accessibility of already-existing services. However, many families do not have access to a central coordinating figure. Since BT care coordination is an emerging subspecialty in Australia, it is critical that neuro-oncology services review and evaluate these positions to ensure that they are adequately integrated and supported.

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Rehabilitation of Adult Patients with Primary Brain Tumors: A Narrative Review

Cited by 28 publications

References 74 publications

Rehabilitation Outcomes for Patients with Motor Deficits after Initial and Repeat Brain Tumor Surgery

Rehabilitation Outcomes for Patients with Motor Deficits after Initial and Repeat Brain Tumor Surgery

Could neurosurgical patients benefit from psychotherapy? A few words on the use of cognitive-behavioural therapy in brain injured patients

“You need someone steering the ship for you”: Australian brain tumour care coordination needs, practices, and opportunities.

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