Functional outcomes of persons with brain tumors after inpatient rehabilitation.
OBJECTIVE
To assess the extent of functional gains measured before and after inpatient rehabilitation in patients who have primary or metastatic brain tumors, and to identify whether the tumor type, recurrent tumor, or ongoing radiation influences outcomes.


METHODS
Retrospective, descriptive study.


METHODS
A free-standing university-affiliated rehabilitation hospital.


METHODS
A referred sample of 132 persons, all with functional impairments from a brain tumor and discharged from inpatient rehabilitation during a 3-year time period.


METHODS
Comprehensive inpatient rehabilitation.


METHODS
Functional status and rate of functional improvement (gain) as measured by the FIM instrument and FIM efficiency.


RESULTS
Mean FIM efficiencies +/- standard deviation for motor (.82 +/-.69) and cognitive (.15 +/-.24) functions were equivalent across primary and metastatic tumor types (F =.42, df = 3,103, p = NS; F =.45, df = 2,104, p = NS, respectively); patients with metastatic disease had a significantly shorter length of stay at 18 +/- 12.3 days (t30,6 = 2.3, p =.03). Patients who received radiation during rehabilitation had a significantly greater (F = 4.1, df = 1,105, p <.05) motor efficiency score (1 +/-.79) than those who did not (.78 +/- 0.7). Patients with recurrent tumors made FIM cognitive changes equivalent to those of persons undergoing rehabilitation after their initial diagnosis, but their motor efficiency scores were significantly smaller (.55 +/-.39 vs.98 +/-.68, respectively) (F = 5.77, df = 1,85, p =.018), which reflected a significantly smaller FIM motor change.


CONCLUSIONS
Metastatic or primary brain tumor type does not affect the efficiency of functional improvement during inpatient rehabilitation. Patients receiving concurrent radiation therapy make greater functional improvement per day than those not receiving radiation. Patients with recurrent tumors make significantly smaller functional motor gains than those completing inpatient rehabilitation after the tumor's initial diagnosis.
Marciniak
C M
CM
Department of Physical Medicine and Rehabilitation, Northwestern University Medical School, Rehabilitation Institute of Chicago, Chicago, IL 60611, USA.
Sliwa
J A
JA
Heinemann
A W
AW
Semik
P E
PE
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000503:physiopathology / Q000534:rehabilitation*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007297:Inpatients; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D016896:Treatment Outcome