Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD.
Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
Arch Phys Med Rehabil. 2021 Nov;102(11):2134-2140. doi: 10.1016/j.apmr.2021.05.001. Epub 2021 May 25.
To examine whether children with brain tumors treated with resection benefit from inpatient rehabilitation and to explore what factors present at admission may predict better functional outcomes.
Retrospective cohort design.
Pediatric inpatient rehabilitation unit.
Forty patients (N=40; ages 3-21y; 42.5% female) admitted to the rehabilitation unit between 2003 and 2015 after brain tumor resection.
Patients received multidisciplinary rehabilitation therapies as part of their admission to inpatient rehabilitation, including occupational, physical, and speech-language therapy.
Functional outcomes included the FIM for Children (WeeFIM) at discharge and 3-month follow-up as well as WeeFIM efficiency.
A repeated-measures analysis of variance using patient WeeFIM Developmental Functional Quotients (DFQs) at admission, discharge, and 3-month follow-up showed significant gains in total WeeFIM DFQ scores across time. Admission WeeFIM DFQ, time from surgery to admission, and age at admission provided the strongest model for predicting discharge and 3-month follow-up WeeFIM DFQ scores. Admission WeeFIM DFQ and time from surgery to admission provided the strongest model for predicting WeeFIM efficiency. Total Neurological Predictor Scale (NPS) at admission did not add predictive power to any of the 3 models over and above patient characteristics (admission WeeFIM DFQ, age at admission, time from surgery to admission).
Patients admitted to inpatient rehabilitation after brain tumor resection made significant functional gains (as measured by the WeeFIM) during inpatient rehabilitation and continued to make significant gains 3 months after discharge. Age and timing of admission provided the strongest models for predicting patient outcomes. The NPS did not predict functional outcomes after rehabilitation when controlling for other variables known to influence rehabilitation outcomes.
探讨接受肿瘤切除术治疗的脑瘤患儿是否能从住院康复中获益，并探索入院时的哪些因素可能预示着更好的功能结局。
回顾性队列设计。
儿科住院康复病房。
40 名（N=40；年龄 3-21 岁；女性占 42.5%）患儿在 2003 年至 2015 年期间于肿瘤切除术后入住康复病房。
患儿接受了多学科康复治疗，作为其住院康复的一部分，包括职业、物理和言语语言治疗。
功能结局包括康复出院时和 3 个月随访时的儿童功能独立性测量（WeeFIM）以及 WeeFIM 效率。
采用患者入院时、出院时和 3 个月随访时的 WeeFIM 发育功能商数（DFQ）的重复测量方差分析显示，总 WeeFIM DFQ 评分随时间显著提高。入院时的 WeeFIM DFQ、手术至入院的时间和入院时的年龄为出院和 3 个月随访时的 WeeFIM DFQ 评分提供了最强的预测模型。入院时的 WeeFIM DFQ 和手术至入院的时间为预测 WeeFIM 效率提供了最强的模型。入院时的总神经预测量表（NPS）在超过患者特征（入院时的 WeeFIM DFQ、入院时的年龄、手术至入院的时间）的情况下，对 3 个模型中的任何一个均未提供预测能力。
接受肿瘤切除术治疗的脑瘤患儿在住院康复期间功能有显著改善（以 WeeFIM 衡量），并且在出院后 3 个月仍有显著改善。年龄和入院时间为预测患者结局提供了最强的模型。在控制已知影响康复结局的其他变量的情况下，NPS 不能预测康复后的功能结局。
