The impact of inpatient rehabilitation on outcomes for patients with cancer

Abstract

The impact of inpatient rehabilitation on outcomes for patients with cancer T he American Cancer Society reports that 1.6 million people are diagnosed with cancer each year, of whom 78% are aged 55 years or older. The 5-year survival rate for cancer is 68%. 1 Almost 15.5 million living Americans have been diagnosed with cancer. 2 Many patients with cancer have difficulty walking and with activities of daily living. Patients with primary brain tumors or tumors metastatic to the brain may present with focal weakness or cognitive deficits similar to patients with stroke. Patients with tumors metastatic to the spine may have the same deficits as a patient with a traumatic spinal cord injury. Patients with metastasis to bone may have pathologic fractures of the hip or long bones. Patients may develop peripheral neuropathy associated with a paraneoplastic syndrome, chemotherapy, or critical illness neuropathy. Lehmann and colleagues evaluated 805 patients admitted to hospitals affiliated with the University of Washington Medical School with a diagnosis of cancer and found that 15% had difficulty walking and 20% had difficulty with activities of daily living. 3 Many patients with cancer can benefit from inpa-tient rehabilitation. 4,5 Study findings have shown that patients with impairments in function related to cancer are often not referred for rehabilitation. Among the reasons mentioned for that are that oncologists are more focused on treating the patients' cancer than on their functional deficits and that specialists in rehabilitation medicine do not want to be involved with patients with complex medical problems. Rehabilitation facilities may not want to incur the costs associated with caring for patients with cancer. 6 The present paper looks at the outcomes of 61 consecutive patients with cancer who were admitted to an inpatient rehabilitation facility (IRF) and received radiation therapy concurrent with rehabilitation. It compares the outcomes of the cancer patients with the outcomes of patients without cancer who were admitted with stroke or spinal cord injury, conditions more commonly treated at an IRF. Methods We reviewed electronic medical records of all patients with cancer admitted to the IRF from 2008 through 2013 who received radiation ther

Inpatient rehabilitation facilities

“…[7] There is a ceiling effect on improvement in FIM. [8] When patients reach an adequate level of function, they are discharged to home. Therefore, properly selected patients at a lower level of function may make more improvement than patients admitted with a higher FIM score.…”

Impact of inpatient rehabilitation services on the functional levels of cancer patients at King Fahad Medical City, Riyadh, Saudi Arabia

“…In contrast to our study results, previous studies showed that approximately 18% of cancer patients with low functional capacity return to an acute setting. 3,4,19 They also found that FIM scores were associated with the return rate to an acute setting. However, the other factors associated with the return of cancer patients to acute care settings are still unclear.…”

“…The existing literature also showed that improvements in FIM scores resulted in decreased strain on resources and burden of caregivers. 3,4 Common barriers to cancer rehabilitation were lack of physician/oncologist knowledge about rehabilitation benefits, lack of rehabilitation facilities, and lack of cooperation between interdisciplinary team members, and these factors negatively affect the functional recovery of cancer survivors. 17 Apart from the above-mentioned factors, the clinical profile of cancer patients admitted to rehabilitation facilities may also affect the overall prognosis and duration of hospital stay.…”

“…7,8 Previous studies have reported that cancer patients benefit from inpatient rehabilitations. [1][2][3][4] However, functional impairments related to cancer are often not referred for specialized rehabilitation services as the main focus of oncologists remains the treatment of the disease rather than the functional deficits it causes. In addition, specialists in rehabilitation medicine and rehabilitation facilities where they practice are keenly aware of the burden and escalating costs that accompany the special care requirements of cancer patientss.…”

“…Approximately one-third of them are limited in their basic activities of daily living (ADL) and have difficulty walking because of disease progression or treatment. 1 - 3 The physical and psychological impairment of cancer survivors negatively affects their quality of life (QOL). 4 , 5 In 2018, the Global Burden of Disease Cancer Collaboration reported that there were 17.2 million people living with cancer worldwide between 2006 and 2016, and the incidence of cancer has increased by approximately 28%.…”