title: Rehabilitation in neuro-oncology: a meta-analysis of published data and a mono-institutional experience.
abstract: BACKGROUND
  Rehabilitation for cancer patients with central nervous system (CNS) involvement is rarely considered and data on its use are limited. The purpose of the present study is to collect all available published data on neuro-oncology rehabilitation and perform a meta-analysis where results were presented in a comparable manner. Moreover, the authors report results on cancer patients with neurological disabilities undergoing rehabilitation at their unit.
  
  
  METHODS
  A PubMed search was performed to identify studies regarding cancer patients with CNS involvement undergoing inpatient physical rehabilitation. Studies with a complete functional evaluation at admission and discharge were selected. As the most common evaluation scales were Functional Independence Measure (FIM) and Barthel Index (BI), only articles with complete FIM and/or BI data were selected for the meta-analysis. Moreover, 23 cancer patients suffering from diverse neurological disabilities underwent standard rehabilitation program between April 2005 and December 2007 at the San Raffaele Pisana Rehabilitation Center. Patient demographics and relevant clinical data were collected. Motricity Index, Trunk Control Test score, and BI were monitored during rehabilitation to assess patient progresses. BI results of patients in this study were included in the meta-analysis.
  
  
  RESULTS
  The meta-analysis included results of a total of 994 patients. A statistically significant (P < .05) improvement of both BI and FIM scores was demonstrated after rehabilitation (standardized mean difference = 0.60 and 0.75, respectively). Functional status determined by either FIM or BI improved on average by 36%.
  
  
  CONCLUSIONS
  Published data demonstrate that patients with brain tumors undergoing inpatient rehabilitation appear to make functional gains in line with those seen in similar patients with nonneoplastic conditions.
authors.affiliation: Medical Oncology Unit, Tor Vergata Clinical Center, University of Rome, Rome, Italy. v.formica@fastwebnet.it
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Formica
authors.forename: Girolamo
authors.initials: G
authors.lastname: Del Monte
authors.forename: Ilaria
authors.initials: I
authors.lastname: Giacchetti
authors.forename: Italia
authors.initials: I
authors.lastname: Grenga
authors.forename: Salvatore
authors.initials: S
authors.lastname: Giaquinto
authors.forename: Massimo
authors.initials: M
authors.lastname: Fini
authors.forename: Mario
authors.initials: M
authors.lastname: Roselli
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000473:pathology / Q000534:rehabilitation* / Q000556:secondary; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012720:Severity of Illness Index; D013117:Spinal Cord Compression / Q000209:etiology / Q000534:rehabilitation; D016896:Treatment Outcome