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多学科住院和门诊康复能否为脑肿瘤患者提供足够的残疾预防?——两个方案的病例系列报告和一项前瞻性、观察性临床试验。

Can Multidisciplinary Inpatient and Outpatient Rehabilitation Provide Sufficient Prevention of Disability in Patients with a Brain Tumor?-A Case-Series Report of Two Programs and A Prospective, Observational Clinical Trial.

机构信息

Department of Rehabilitation in the Greater Poland Cancer Centre, 15 Garbary St. 61-866 Poznan, Poland.

Neurorehabilitation Ward, Provincial Hospital in Poznan, 9-14 Juraszow St. 60-479 Poznan, Poland.

出版信息

Int J Environ Res Public Health. 2020 Sep 6;17(18):6488. doi: 10.3390/ijerph17186488.

DOI:10.3390/ijerph17186488
PMID:32899993
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7559888/
Abstract

Brain tumor (BT) patients have a high incidence of disability due to the effects of the tumor itself or oncological treatment. Despite the incidence of neurological and functional deficits caused by BT, rehabilitation of those patients is not as properly established as in patients with other neurological conditions. The aim of the research was to evaluate the effectiveness of a multidisciplinary rehabilitation, carried out as an out- or in-patient program, as prevention of disability in BT patients. This was developed as a case-series report of two programs and a prospective, observational clinical study in BT patients who were allocated to inpatient (n = 28) or outpatient (n = 26) rehabilitation programs. The patients were assessed using the Barthel Index, Berg Balance Scale, Functional Independence Measure (FIM), Functional Assessment of Cancer Therapy-Brain and Cognitive Function, and Addenbrooke's Cognitive Examination III (ACE III) upon admission and after 12 weeks of rehabilitation. Analysis of the results showed that patients in both programs significantly improved their physical functioning scores in daily activities ( < 0.0001). We also observed significant reductions in most post-intervention cognitive complaints ( < 0.05), except for the FIM social functioning and ACE III language functioning in the outpatient group ( > 0.05) in contrast to inpatients ( < 0.001). This is evidence that early multidisciplinary rehabilitation is an effective therapeutic strategy to reduce BT symptoms and disability in this group of patients.

摘要

脑肿瘤(BT)患者由于肿瘤本身或肿瘤治疗的影响,残疾发生率较高。尽管 BT 会导致神经和功能缺陷,但与其他神经疾病患者相比,对这些患者的康复治疗并没有得到很好的建立。本研究的目的是评估作为门诊或住院患者康复计划的多学科康复治疗对 BT 患者残疾的预防效果。本研究以两个方案的病例系列报告和对分配到住院(n = 28)或门诊(n = 26)康复方案的 BT 患者的前瞻性观察性临床研究的形式开展。患者入院时和康复 12 周后使用巴氏指数、伯格平衡量表、功能独立性测量(FIM)、癌症治疗脑功能和认知功能评估量表以及 Addenbrooke 认知测验第三版(ACE III)进行评估。结果分析显示,两个方案的患者在日常生活活动中的身体功能评分均显著提高(<0.0001)。我们还观察到大多数干预后认知问题(<0.05)显著减少,除了门诊组的 FIM 社会功能和 ACE III 语言功能(>0.05)与住院组(<0.001)相比。这表明早期多学科康复是一种有效的治疗策略,可以减少 BT 患者的症状和残疾。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7daa/7559888/17049fdb24db/ijerph-17-06488-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7daa/7559888/17049fdb24db/ijerph-17-06488-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7daa/7559888/17049fdb24db/ijerph-17-06488-g001.jpg

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