title: Rehabilitation needs in oncological patients: the On-rehab project results on patients operated for musculoskeletal tumors.
abstract: BACKGROUND
  Rehabilitation plays an important role in improving functional outcome in patients operated on musculoskeletal tumors. Literature in the field is scarce and the specific needs for rehabilitation of these patients are still unknown.
  
  
  OBJECTIVE
  To analyze the rehabilitation needs of patients with primary malignant musculoskeletal tumors.
  
  
  METHODS
  Observational, longitudinal study on both inpatient and outpatient operated on musculoskeletal tumors.
  
  
  METHODS
  Rehabilitation needs of oncological patients were explored by means of questionnaires administered by a physician. Demographic, oncological, psychological domains were also assessed.
  
  
  RESULTS
  Twenty-nine patients were evaluated in the immediate post-operative period, 25 patients had a follow up at 6 months, and 11 patients at 12 months. Rehabilitation needs concerned essentially the neuromotor function and the improvement of independence at home/outside home. At first admission, support for occupational rehabilitation was also relevant, while its importance was reduced over the follow-up. Pain control need was greater at first admission (VAS over the follow-up 3.3, 0.52, and 1.09, respectively) and required treatment with painkillers. Quality of life (EORTC) increased over the three assessments (respectively 48.80; 71.42; 82.14). The Psychological Distress Inventory (PDI) scores were 26.23, 21.75, 23.6, and the Caregiver Needs Assessment (CNA) scores were 32.69, 27.95, and 31.7 respectively at the three follow up.
  
  
  CONCLUSIONS
  The relevant domains in which rehabilitation needs emerged in up to 1 year follow up were the neuromotor area in order to gain independence at home and outside the home, pain control, particularly after surgery, nursing, psychological support of patients and caregivers, and occupational activities (personal, work, school, social).
  
  
  CONCLUSIONS
  The findings of the present study suggest that: short and midterm clinical rehabilitation programs should be made available for patients operated on musculoskeletal tumors. Physical function recovery is only one aspect of rehabilitation, and psychosocial functioning must be taken into account and coordinated by a comprehensive team of specialists. Appropriate assessment tools should be used, and a continuum of care from the hospital to the patient's home should be promoted.
authors.affiliation: Physical Medicine and Rehabilitation Unit, Istituto Ortopedico Rizzoli, Bologna, Italy - benedetti@ior.it.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Benedetti
authors.affiliation: Physical Medicine and Rehabilitation Unit, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Silayan
authors.initials: S
authors.lastname: Erfe Delayon
authors.affiliation: 3rd Orthopedic and Traumatologic Oncologic Clinic, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Colangeli
authors.affiliation: Physical Medicine and Rehabilitation Unit, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Parisini
authors.affiliation: Chemotherapy Ward of Musculoskeletal Tumors, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Ferrari
authors.affiliation: 3rd Orthopedic and Traumatologic Oncologic Clinic, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Manfrini
authors.affiliation: Functional Recovery and Rehabilitation Unit, Neuromotor/Oncologic Sections, Fondazione Salvatore Maugeri, Pavia, Italy.
authors.forename: Isabella
authors.initials: I
authors.lastname: Springhetti
mesh_terms: D001859:Bone Neoplasms / Q000150:complications / Q000523:psychology / Q000534:rehabilitation* / Q000601:surgery; D000072716:Cancer Pain / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D023821:Limb Salvage / Q000379:methods / Q000534:rehabilitation*; D008137:Longitudinal Studies; D008297:Male; D019042:Muscle Neoplasms / Q000150:complications / Q000534:rehabilitation*; D059352:Musculoskeletal Pain / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation* / Q000601:surgery; D020380:Needs Assessment; D010149:Postoperative Pain / Q000523:psychology / Q000534:rehabilitation*; D011788:Quality of Life; D055815:Young Adult