| 저자 |
Junghoon Yu1*, Youngsu Jung1, Joonhyun Park1, Jong Moon Kim1,2, Miri Suh1,2, MinYoung Kim1,2† |
Introduction
Brain tumor is one of the major causes of disability. Although advances of therapies led improvement of survival rate of victims, neuro-surgeon, neuro-oncologist and even physiatrist are not so interested in rehabilitation due to still poor survival and high recurrence rate. To evaluate substantial meaning of rehabilitation, we assessed two aspects. One is efficacy of intensive rehabilitation for neurological impairment in patients by comparing with stroke patients, for whom rehabilitation is world widely accepted as basic therapy. Other is perceived worth about rehabilitation by patients and caregivers long-term after period of intensive rehabilitation.
Methods
Patients with neurological impairments after tumor surgery who received intensive rehabilitation under hospitalization during December, 2013-May, 2017 were included. Stroke patients, who also received intensive rehabilitation at same duration by same rehabilitation team under same strategy, were included as control group to evaluate therapeutic efficacy. Retrospectively, scores of functional evaluations which conducted before and after intensive rehabilitation, were analyzed: Fugl-Meyer assessment, Berg balance scale, modified Barthel index, and psychological assessments including mini-mental state examination and Wechsler’s intelligence quotient. As for worth-perceiving evaluation for therapy, subjective satisfaction was assessed by telephone-survey on 6 items about functional improvements, intensity of therapy, overall satisfaction, and whether recommend rehabilitation to other patients. Information on long term function and survival status were collected.
Results
Rehabilitation outcomes were collected from 21 benign and 14 malignant brain tumor; and 108 stroke patients. Telephone survey was available in 17 benign and 9 malignant patients. Rehabilitation resulted in significantly equal improvement in brain tumor patients on every outcome measures compared to stroke regardless of malignancy status (Table 1, Figure 1.). Two patients with benign tumor and nine with malignant had expired. In survivors, over 80% caregivers answered that motor, ADL, and cognition has improved or maintained compared with discharge (Figure 2A). Over 60% caregivers answered that rehabilitation was effective in improving motor, ADL, and cognition. Around 70% answered positively about overall satisfaction, intensity, and recommend rehabilitation to other patients. (Figure 2B). Impressively, the pattern was similar in malignant (Figure 2C) and in deceased cases (Figure 2D).
Conclusion
In conclusion, the intensive rehabilitation brought functional improvement in brain tumor patients regardless of malignancy status, and caregivers expressed high satisfaction about rehabilitation. Therefore, intensive rehabilitation in brain tumor patients is worthwhile and medical staffs should draw more attention to provide appropriate rehabilitation therapy for brain tumor patients with neurological impairment. |
