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Year : 2022  |  Volume : 5  |  Issue : 1  |  Page : 27-32

Exploring the value of neuro-oncological rehabilitation within a neurorehabilitation setting

1 Department of Neurorehabilitation, PDRU, Queen Elizabeth University Hospital, Glasgow, United Kingdom
2 Department of Neurorehabilitation, Astley Ainslie Hospital, Edinburgh, United Kingdom

Correspondence Address:
Dr. Teng Cheng Khoo
PDRU, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF
United Kingdom
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jisprm.JISPRM-000152

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Background: Cancer rehabilitation is gaining recognition in response to treatment advances, with more survivors living with functional impairments. This study aims to describe the outcomes from neuro-oncological rehabilitation within an inpatient neurorehabilitation setting, focusing on patients with malignancy. Subjects and Methods: A review of neuro-oncological admissions from 2009 to 2017 was performed comparing length of stay (LOS), changes in United Kingdom Functional Independence Measure + Functional Assessment Measure (UK FIM + FAM) scores, discharge outcome, and survival between patients with benign and malignant diagnoses. Results: One hundred and twenty patients were included (40% with malignancy). Eighteen percent required transfer back to acute setting due to cancer- or treatment-related complications. Having malignancy was associated with a higher rate of acute transfer (34% vs. 7%, x2 = 13.8, P < 0.01). LOS was not significantly different between the two groups (median difference: 5 days, 95% confidence interval [CI]: −8–18, P = 0.187). While UK FIM + FAM change was significantly lower in the malignant group, the corresponding lower UK FIM + FAM efficiency was not (mean difference: 16, 95% CI: 1–31, P = 0.043 and 0.18, −0.42–0.05, P = 0.114, respectively). The median survival in the malignant group was 3.2 months (95% CI: 2.0–8.4), with survival up to 40.4 months. Conclusion: While patient outcomes with benign and malignant diagnoses were similar, the UK FIM + FAM does not capture the full benefit of rehabilitation. Given that patients with malignancy have limited survival, quality of life measures and goal attainment scaling may be more appropriate. Effective and efficient inpatient neuro-oncological rehabilitation in malignancy is deliverable, but collaboration with both oncology and palliative care services is crucial.

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