Ann Rehabil Med.  2019 Apr;43(2):129-141. 10.5535/arm.2019.43.2.129.

Intensive Rehabilitation Therapy Following Brain Tumor Surgery: A Pilot Study of Effectiveness and Long-Term Satisfaction

• Yu J
• Jung Y
• Park J
• Kim JM
• Suh M
• Cho KG
• Kim M

• KMID: 2448995
• DOI: http://doi.org/10.5535/arm.2019.43.2.129

Abstract

OBJECTIVE
To evaluate the effectiveness of intensive rehabilitation to support recovery of neurological function after brain tumor surgery and assess long-term satisfaction.
METHODS
This retrospective study included patients with neurological impairment after brain tumor surgery who underwent intensive rehabilitation therapy between December 2013 and May 2017. To assess effectiveness of rehabilitation, functional outcomes (motor, cognition, and activities of daily living [ADL]) were compared between brain tumor group and a control group enrolling stroke patients who received equivalent rehabilitation during the study period. Long-term satisfaction with rehabilitation was evaluated by surveying family caregivers.
RESULTS
This study included 21 patients with benign brain tumor, 14 with malignant brain tumor, and 108 with stroke. Significant and similar improvement in motor, cognition, and ADL function were noted in both the brain tumor group and the stroke group. Malignancy status did not influence the extent of functional improvement. According to medical records and surveys, 9 (69.2%) patients with malignant tumor and 2 (11.8%) with benign tumor had expired by the time of the survey. Most family caregivers confirmed that rehabilitation was effective for functional improvement (>60%), expressing overall satisfaction and stating they would recommend such therapy to patients with similar conditions (approximately 70%).
CONCLUSION
Intensive rehabilitation may help promote functional improvement following brain tumor surgery regardless of malignancy compared with stroke patients. Family caregivers expressed overall satisfaction with rehabilitation at long-term follow-up. These findings support the provision of intensive rehabilitation therapy for neurologic function recovery following brain tumor surgery.

Keyword

Brain neoplasms; Treatment outcome; Satisfaction; Neurological rehabilitation

MeSH Terms

Activities of Daily Living
Brain Neoplasms*
Brain*
Caregivers
Cognition
Follow-Up Studies
Humans
Medical Records
Neurological Rehabilitation
Pilot Projects*
Recovery of Function
Rehabilitation*
Retrospective Studies
Stroke
Treatment Outcome

Figure

• 

  Fig. 1. Recruitment flowchart detailing the number of participants included and excluded. WHO, World Health Organization.

• 

  Fig. 2. Comparison of rehabilitation outcome for (A) efficiencies in brain tumor and stroke groups, and (B) efficiencies in malignant and benign brain tumor groups. There is no significant difference when efficiencies between two groups (brain tumor vs. stroke and malignant vs. benign brain tumor) are compared by Mann-Whitney U test. The bold line in the box represents the median value. The interquartile range box represents the middle 50% of each data. The whisker represents ranges for the bottom 25% and the top 25%, excluding outliers. FMA, Fugl-Meyer Assessment; BBS, Berg Balance Scale; K-MBI, Korean version of Modified Barthel Index; K-MMSE, Korean Mini-Mental State Examination; IQ, intelligence quotient.

• 

  Fig. 3. Survival estimates in patients with brain tumor. The survival rate was analyzed using the Kaplan-Meier survival curve. Cumulative survival probability is drawn according to different pathology (benign vs. malignant) in brain tumor since brain tumor operation (A) and initiation of rehabilitation therapy (B). (A) Since brain tumor operation, overall mean survival was 93.6 months. It was 116.6 months and 52.9 months for benign and malignant tumors, respectively. (B) Since initiation of rehabilitation therapy, overall mean survival was 89.3 months. It was 112.6 months and 48.4 months for benign and malignant tumors, respectively.

• 

  Fig. 4. Results of telephone survey about current functions in patients with brain tumor. Opinion of family caregivers on current status of motor, activities of daily living (ADL), and cognitive function compared to the status on discharge in survived patients (3-point scale: improved, similar, and worsened) in benign brain tumor patients (n=15) (A) and malignant brain tumor patients (n=4) (B).

• 

  Fig. 5. Results of telephone survey about satisfaction in patients with brain tumor. (A) Brain tumor patients in total (n=26), (B) patients with malignant brain tumor (n=9), and (C) deceased patients with both benign and malignant brain tumor (n=7) are depicted.

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