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

  • Clinical Study - Patient Study
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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.

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Acknowledgments

The authors thank Catherine Wrenn who revised English language. Michelangelo Bartolo conceived the study, collected data, performed statistical analysis, interpreted the results, and wrote the paper. Chiara Zucchella conceived the study, performed statistical analysis, interpreted the results, and wrote the paper. Carmine Vecchione is a consultant cardiologist, who collected data and revised the first draft of the manuscript. Gaetano Lanzetta is a consultant oncologist, who collected data and revised the first draft of the manuscript. Mariano Serrao performed statistical analysis and revised the first draft of the manuscript. Cristina Tassorelli interpreted data and revised the manuscript. Marcello Bartolo and Giovanni Grillea performed neuroradiological examinations and collected data. Andrea Pace, Francesco Pierelli, and Giorgio Sandrini interpreted data and revised the last version of the paper.

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Authors and Affiliations

  1. Neurorehabilitation Unit, IRCCS NEUROMED Mediterranean Neurological Institute, Via Atinense, 18, 86077, Pozzilli, Isernia, Italy

    Michelangelo Bartolo, Gaetano Lanzetta & Francesco Pierelli

  2. Neurology Unit, Palliative Home-Care Unit for Brain Tumour Patients, Regina Elena National Cancer Institute, Rome, Italy

    Chiara Zucchella & Andrea Pace

  3. Laboratory of Neuropsychology, IRCCS National Neurological Institute C. Mondino Foundation, Pavia, Italy

    Chiara Zucchella

  4. Stroke Unit, IRCCS NEUROMED Mediterranean Neurological Institute, Pozzilli, Isernia, Italy

    Carmine Vecchione

  5. Neuroradiological Unit, IRCCS NEUROMED Mediterranean Neurological Institute, Pozzilli, Isernia, Italy

    Marcello Bartolo & Giovanni Grillea

  6. Neurorehabilitation Unit, “Sapienza” University of Rome-Polo Pontino, Latina, Italy

    Mariano Serrao & Francesco Pierelli

  7. Rehabilitation Centre, Policlinico Italia, Rome, Italy

    Mariano Serrao

  8. Neurorehabilitation Unit, IRCCS National Neurological Institute C. Mondino Foundation, Pavia, Italy

    Cristina Tassorelli & Giorgio Sandrini

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  1. Michelangelo Bartolo
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  2. Chiara Zucchella
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  4. Gaetano Lanzetta
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  6. Marcello Bartolo
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  7. Giovanni Grillea
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  8. Mariano Serrao
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  10. Giorgio Sandrini
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  11. Francesco Pierelli
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Correspondence to Michelangelo Bartolo.

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Bartolo, M., Zucchella, C., Pace, A. et al. Early rehabilitation after surgery improves functional outcome in inpatients with brain tumours. J Neurooncol 107, 537–544 (2012). https://doi.org/10.1007/s11060-011-0772-5

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  • DOI: https://doi.org/10.1007/s11060-011-0772-5

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