title: Controlled rehabilitative and supportive care intervention trials in patients with high-grade gliomas and their caregivers: a systematic review.
abstract: BACKGROUND
  Patients diagnosed with high-grade gliomas experience a varying and complex symptom burden, and face a high mortality rate. As a consequence, patients with high-grade gliomas and their caregivers have imminent and changing rehabilitative and supportive care needs.
  
  
  OBJECTIVE
  To give a detailed overview of non-pharmacological rehabilitative and supportive care interventions for patients with high-grade gliomas and/or their caregivers, and provide an appraisal of the methodological quality of these studies.
  
  
  METHODS
  PubMed, Cumulative Index of Nursing and Allied Health Literature and Embase were searched for literature published from 1995 to May 2013. Data from eight studies were reviewed for substantive methods and results. Methodological quality was described and assessed using the scoring system for appraising mixed methods research and concomitantly appraising qualitative, quantitative and mixed methods primary studies in mixed study reviews.
  
  
  RESULTS
  The search yielded 914 unique publications, of which 9 were classified eligible for this review. There is preliminary evidence that cognitive group therapy improves memory skills in patients with high-grade gliomas, early physical training improves functional outcome and massage therapy reduces stress. Patients and caregivers found that telephone follow-up and a specialist nurse function was an effective and useful way to achieve information and support. Finally, psycho-education increased feelings of mastery among caregivers.
  
  
  CONCLUSIONS
  As evidence is beginning to emerge, there is a need for well-designed longitudinal and randomised controlled trials of non-pharmacological interventions in high-grade glioma patients and their caregivers in order to develop clinical guidelines for supportive and rehabilitative approaches in this unique population.
authors.affiliation: Department of Neurosurgery, The University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark The University Hospitals Center for Health Research (UCSF), Center for Integrated Rehabilitation for Patients with Cancer (CIRE), Copenhagen, Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Piil
authors.affiliation: Department of Neurosurgery, The University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark Department of Clinical Medicine, Section of Neurology, Psychiatry and Sensory Sciences, The University of Copenhagen, Copenhagen K, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Juhler
authors.affiliation: The University Hospital of Copenhagen; Rigshospitalet, Neuroscience Center, Copenhagen, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Jakobsen
authors.affiliation: The University Hospitals Center for Health Research (UCSF), Center for Integrated Rehabilitation for Patients with Cancer (CIRE), Copenhagen, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Jarden
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000534:rehabilitation*; D017028:Caregivers; D015928:Cognitive Behavioral Therapy; D018849:Controlled Clinical Trials as Topic; D005260:Female; D005910:Glioma / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D016032:Randomized Controlled Trials as Topic; D012944:Social Support; D016896:Treatment Outcome; D055815:Young Adult