Effectiveness of integrated multidisciplinary rehabilitation in primary brain cancer survivors in an Australian community cohort: a controlled clinical trial

J Rehabil Med. 2014 Sep;46(8):754-60. doi: 10.2340/16501977-1840.

Abstract

Objective: To evaluate effectiveness of a multidisciplinary rehabilitation program for persons following definitive primary brain tumour treatment in a community cohort.

Methods: The brain tumour (glioma) survivors (n = 106) were allocated either to the treatment group (n = 53) (intensive ambulatory multidisciplinary rehabilitation), or the waitlist control group (n = 53). The primary outcome - Functional Independence Measure (FIM), measured 'Activity' limitation; secondary measures included Depression, Anxiety Stress Scale, Perceived Impact Problem Profile and Cancer Rehabilitation Evaluation System. Assessments were at baseline, 3 and 6 months after program completion.

Results: Participants were predominantly women (56%), with mean age 51 years (standard deviation 13.6) and median time since diagnosis of 2.1 years. Intention-to-treat analysis showed a significant difference between groups at 3-month in favour of multidisciplinary rehabilitation program in FIM motor subscales: 'self-care', 'sphincter', 'locomotion', 'mobility'(p < 0.01 for all); and FIM 'communication' (p < 0.01) and 'psychosocial' subscales (p < 0.05), with small to moderate effect size (r = 0.2-0.4). At 6-month follow-up, significant improvement in the treatment group was maintained only for FIM 'sphincter', 'communication' and 'cognition' subscales (p < 0.01 for all). No difference between groups was noted in other subscales.

Conclusions: brain tumour survivors can improve function with multidisciplinary rehabilitation, with some gains maintained up to 6 months. Evidence for specific interventions in the 'blackbox' of rehabilitation is needed.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Activities of Daily Living / psychology*
  • Adult
  • Aged
  • Ambulatory Care
  • Analysis of Variance
  • Anxiety / diagnosis
  • Anxiety / etiology
  • Anxiety / rehabilitation*
  • Brain Neoplasms / classification
  • Brain Neoplasms / complications
  • Brain Neoplasms / psychology
  • Brain Neoplasms / rehabilitation*
  • Depression / diagnosis
  • Depression / etiology
  • Depression / rehabilitation*
  • Female
  • Glioma / classification
  • Glioma / rehabilitation*
  • Humans
  • International Classification of Functioning, Disability and Health
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Life*
  • Self Care
  • Survivors / psychology
  • Victoria
  • Young Adult