Fary Khan1, Bhasker Amatya, Kate Drummond, Mary Galea. 1. Department of Rehabilitation Medicine, Royal, Melbourne Hospital, 34-54 Poplar Road, Parkville, Melbourne VIC 3052, Australia. fary.khan@mh.org.au.
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.
RCT Entities:
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.
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