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髓外硬膜内肿瘤切除术后癌症功能评估集和功能独立性测量的变化:病例报告

Changes in Cancer Functional Assessment Set and Functional Independence Measure After Intradural Extramedullary Tumor Resection: A Case Report.

作者信息

Nakamura Junko

机构信息

Rehabilitation, Itami Seifu Hospital, Itami, JPN.

出版信息

Cureus. 2020 Oct 26;12(10):e11184. doi: 10.7759/cureus.11184.

Abstract

BACKGROUND AND PURPOSE

The Cancer Functional Assessment Set (cFAS) was developed as a scale for assessing physical function specifically for cancer patients. It is a scale that allows for accurate assessment of physical functioning and the effectiveness of rehabilitation interventions in cancer patients. Here we reported a case of the use of cFAS in rehabilitation after thoracic intradural extramedullary tumor resection.

CASE DESCRIPTION

A thoracic spine magnetic resonance imaging scan showed an intradural extramedullary tumor of Th6, which was resected. Postoperatively, the patient was transferred to the recovery unit of our hospital. The residual ataxia symptoms derived from posterior cord symptoms were characteristic of this case.

INTERVENTION

Using cFAS and Functional Independence Measure (FIM) as indices for evaluation, physical therapy was aimed at improving ataxic gait and occupational therapy was performed for impairment of activities of daily living. These treatments were performed for three hours a day during the hospitalization.

OUTCOMES

Ataxic gait from position sense disturbance due to posterior compression of the spinal cord was present. The FIM (motor component) and cFAS at admission were 58 and 55 points, respectively. Rehabilitation was continued, and the FIM (motor component) and cFAS at discharge were 88 and 86 points, respectively, both showing improvement relative to admission. The patient was discharged 69 days after surgery.

DISCUSSION

Both cFAS and FIM improved after surgery with rehabilitation, reflecting improvement in activities of daily living during recovery from position sense disturbance. Previous cFAS studies had included gastrointestinal, pulmonary, brain, hematologic, genitourinary, genitourinary, head and neck cancers. cFAS may furthermore be a useful tool for assessing spinal cord tumors, particularly in the presence of posterior cord injury.

摘要

背景与目的

癌症功能评估量表(cFAS)是专门为评估癌症患者身体功能而制定的量表。该量表能够准确评估癌症患者的身体功能以及康复干预的效果。在此,我们报告1例应用cFAS评估胸椎硬脊膜外髓外肿瘤切除术后康复情况的病例。

病例描述

胸椎磁共振成像扫描显示胸6硬脊膜外髓外肿瘤,遂行肿瘤切除术。术后,患者转入我院康复科。该病例的特点是存在源于脊髓后索症状的残余共济失调症状。

干预措施

以cFAS和功能独立性测量(FIM)作为评估指标,物理治疗旨在改善共济失调步态,针对日常生活活动障碍进行作业治疗。住院期间,这些治疗每天进行3小时。

结果

患者因脊髓后部受压导致位置觉障碍,存在共济失调步态。入院时FIM(运动部分)和cFAS分别为58分和55分。继续进行康复治疗,出院时FIM(运动部分)和cFAS分别为88分和86分,均较入院时有所改善。患者术后69天出院。

讨论

术后经康复治疗,cFAS和FIM均有所改善,反映出从位置觉障碍恢复过程中日常生活活动能力的提高。既往cFAS研究纳入了胃肠道、肺部、脑部、血液、泌尿生殖系统、头颈部癌症。cFAS可能还是评估脊髓肿瘤的有用工具,尤其是在存在脊髓后索损伤的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f1c/7593215/abd83ec72efc/cureus-0012-00000011184-i01.jpg

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