Effectiveness of integrated multidisciplinary rehabilitation in primary brain cancer survivors in
an Australian community cohort: a controlled clinical trial
Engelsk titel: Effectiveness of integrated multidisciplinary rehabilitation in primary brain cancer survivors in an
Australian community cohort: a controlled clinical trial
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Författare:
Khan, Fary
;
Amatya, Bhasker
;
Drummond, Kate
;
Galea, Mary
Email: fary.khan@mh.org.au
Språk: Eng
Antal referenser: 40
Dokumenttyp:
CCT
UI-nummer: 15029316
Sammanfattning
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.