Physical Therapy Department, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Boulevard 28 de Setembro, no. 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil.
Master's Program in Public Health, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
Support Care Cancer. 2018 Sep;26(9):3225-3231. doi: 10.1007/s00520-018-4182-5. Epub 2018 Apr 6.
This prospective study was conducted to evaluate the functional status and clinical features of inpatients with metastatic spinal cord compression and to explore possible associated factors and the correlation with neurological deficits.
Cases were identified through an active search in the hospital units of the National Cancer Institute. For 47 patients, clinical and demographic characteristics were collected; functional status was measured by the Functional Independence Measure; modified Tokuhashi score was used to predict survival time; neurological deficits were measured using the American Spinal Injury Association Impairment Scale; and general condition was evaluated using the Karnofsky Performance Status Scale. The correlation between the level of neurological deficits and functional status was calculated using the Spearman correlation test. The difference in the functional independence score according to neurological status was assessed with the Kruskall-Wallis test.
The degree of functional status was associated with Karnofsky Performance Status, level of neurological deficits, ability to walk, survival time, and skin color (p < 0.05). There was difference in the functional status (p = 0.004) and in the motor domain (p = 0.001) according to the level of neurological deficits. The correlation of the Functional Independence Measure with level of neurological deficits and with Karnofsky Performance Status was moderate (r = 0.46, p < 0.02).
The Functional Independence Measure was adequate for evaluating the functional status of patients with metastatic spinal cord compression. Palliative rehabilitation should be integrated early and strategies should be linked to the prognosis of survival.
本前瞻性研究旨在评估转移性脊髓压迫症住院患者的功能状态和临床特征，并探讨可能的相关因素及其与神经功能缺损的相关性。
通过在国家癌症研究所的医院科室进行主动搜索，确定了病例。对 47 名患者收集了临床和人口统计学特征；使用功能独立性测量法评估功能状态；使用改良 Tokuhashi 评分预测生存时间；使用美国脊髓损伤协会损伤量表评估神经功能缺损；使用 Karnofsky 表现状态量表评估一般状况。使用 Spearman 相关检验计算神经功能缺损程度与功能状态之间的相关性。使用 Kruskall-Wallis 检验评估根据神经状态的功能独立性评分差异。
功能状态程度与 Karnofsky 表现状态、神经功能缺损程度、行走能力、生存时间和肤色有关（p<0.05）。根据神经功能缺损程度，功能状态（p=0.004）和运动域（p=0.001）存在差异。功能独立性测量法与神经功能缺损程度和 Karnofsky 表现状态的相关性为中度（r=0.46，p<0.02）。
功能独立性测量法可充分评估转移性脊髓压迫症患者的功能状态。姑息性康复治疗应尽早纳入，并应根据生存预后制定相应策略。
