Marciniak C M, Sliwa J A, Heinemann A W, Semik P E
Department of Physical Medicine and Rehabilitation, Northwestern University Medical School, Rehabilitation Institute of Chicago, Chicago, IL 60611, USA.
Arch Phys Med Rehabil. 2001 Apr;82(4):457-63. doi: 10.1053/apmr.2001.21862.
To assess the extent of functional gains measured before and after inpatient rehabilitation in patients who have primary or metastatic brain tumors, and to identify whether the tumor type, recurrent tumor, or ongoing radiation influences outcomes.
Retrospective, descriptive study.
A free-standing university-affiliated rehabilitation hospital.
A referred sample of 132 persons, all with functional impairments from a brain tumor and discharged from inpatient rehabilitation during a 3-year time period.
Comprehensive inpatient rehabilitation.
Functional status and rate of functional improvement (gain) as measured by the FIM instrument and FIM efficiency.
Mean FIM efficiencies +/- standard deviation for motor (.82 +/-.69) and cognitive (.15 +/-.24) functions were equivalent across primary and metastatic tumor types (F =.42, df = 3,103, p = NS; F =.45, df = 2,104, p = NS, respectively); patients with metastatic disease had a significantly shorter length of stay at 18 +/- 12.3 days (t30,6 = 2.3, p =.03). Patients who received radiation during rehabilitation had a significantly greater (F = 4.1, df = 1,105, p <.05) motor efficiency score (1 +/-.79) than those who did not (.78 +/- 0.7). Patients with recurrent tumors made FIM cognitive changes equivalent to those of persons undergoing rehabilitation after their initial diagnosis, but their motor efficiency scores were significantly smaller (.55 +/-.39 vs.98 +/-.68, respectively) (F = 5.77, df = 1,85, p =.018), which reflected a significantly smaller FIM motor change.
Metastatic or primary brain tumor type does not affect the efficiency of functional improvement during inpatient rehabilitation. Patients receiving concurrent radiation therapy make greater functional improvement per day than those not receiving radiation. Patients with recurrent tumors make significantly smaller functional motor gains than those completing inpatient rehabilitation after the tumor's initial diagnosis.
评估原发性或转移性脑肿瘤患者在住院康复前后所测得的功能改善程度，并确定肿瘤类型、复发性肿瘤或正在进行的放疗是否会影响康复结果。
回顾性描述性研究。
一家独立的大学附属医院康复医院。
132例转诊患者，均因脑肿瘤导致功能障碍，并在3年期间内从住院康复中出院。
全面的住院康复治疗。
采用FIM工具和FIM效率来衡量功能状态和功能改善率（增益）。
原发性和转移性肿瘤类型的运动功能（.82±.69）和认知功能（.15±.24）的平均FIM效率±标准差相当（F = 0.42，自由度= 3,103，p =无显著性差异；F = 0.45，自由度= 2,104，p =无显著性差异）；转移性疾病患者的住院时间明显较短，为18±12.3天（t30,6 = 2.3，p = 0.03）。康复期间接受放疗的患者的运动效率得分（1±0.79）明显高于未接受放疗的患者（.78±0.7）（F = 4.1，自由度= 1,105，p <0.05）。复发性肿瘤患者的FIM认知变化与初次诊断后接受康复治疗的患者相当，但其运动效率得分明显较低（分别为.55±.39和.98±.68）（F = 5.77，自由度= 1,85，p = 0.018），这反映出FIM运动变化明显较小。
转移性或原发性脑肿瘤类型不影响住院康复期间功能改善的效率。接受同步放疗的患者每天的功能改善比未接受放疗的患者更大。复发性肿瘤患者的功能运动增益明显小于肿瘤初次诊断后完成住院康复的患者。
