Danielle Zacaron Santos1, Isabel Cristina Gonçalves Leite2, Maximiliano Ribeiro Guerra2,3. 1. Physical Therapy Department, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Boulevard 28 de Setembro, no. 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil. daniellezacaron@gmail.com. 2. Master's Program in Public Health, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. 3. Inserm U900, Paris Institut Curie, Paris Mines ParisTech, Fontainebleau, PSL Research University, Paris, France.
Abstract
PURPOSE: This prospective study was conducted to evaluate the functional status and clinical features of inpatients with metastatic spinal cord compression and to explore possible associated factors and the correlation with neurological deficits. METHODS: Cases were identified through an active search in the hospital units of the National Cancer Institute. For 47 patients, clinical and demographic characteristics were collected; functional status was measured by the Functional Independence Measure; modified Tokuhashi score was used to predict survival time; neurological deficits were measured using the American Spinal Injury Association Impairment Scale; and general condition was evaluated using the Karnofsky Performance Status Scale. The correlation between the level of neurological deficits and functional status was calculated using the Spearman correlation test. The difference in the functional independence score according to neurological status was assessed with the Kruskall-Wallis test. RESULTS: The degree of functional status was associated with Karnofsky Performance Status, level of neurological deficits, ability to walk, survival time, and skin color (p < 0.05). There was difference in the functional status (p = 0.004) and in the motor domain (p = 0.001) according to the level of neurological deficits. The correlation of the Functional Independence Measure with level of neurological deficits and with Karnofsky Performance Status was moderate (r = 0.46, p < 0.02). CONCLUSION: The Functional Independence Measure was adequate for evaluating the functional status of patients with metastatic spinal cord compression. Palliative rehabilitation should be integrated early and strategies should be linked to the prognosis of survival.
PURPOSE: This prospective study was conducted to evaluate the functional status and clinical features of inpatients with metastatic spinal cord compression and to explore possible associated factors and the correlation with neurological deficits. METHODS: Cases were identified through an active search in the hospital units of the National Cancer Institute. For 47 patients, clinical and demographic characteristics were collected; functional status was measured by the Functional Independence Measure; modified Tokuhashi score was used to predict survival time; neurological deficits were measured using the American Spinal Injury Association Impairment Scale; and general condition was evaluated using the Karnofsky Performance Status Scale. The correlation between the level of neurological deficits and functional status was calculated using the Spearman correlation test. The difference in the functional independence score according to neurological status was assessed with the Kruskall-Wallis test. RESULTS: The degree of functional status was associated with Karnofsky Performance Status, level of neurological deficits, ability to walk, survival time, and skin color (p < 0.05). There was difference in the functional status (p = 0.004) and in the motor domain (p = 0.001) according to the level of neurological deficits. The correlation of the Functional Independence Measure with level of neurological deficits and with Karnofsky Performance Status was moderate (r = 0.46, p < 0.02). CONCLUSION: The Functional Independence Measure was adequate for evaluating the functional status of patients with metastatic spinal cord compression. Palliative rehabilitation should be integrated early and strategies should be linked to the prognosis of survival.
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