INTRODUCTION: Persons with brain tumours can experience a range of symptoms and disabilities, such as psychological problems, difficulties with mobility or self care, relationship and work issues, which can substantially impact their quality of life. The mentioned symptoms may be amenable to interdisciplinary rehabilitation after surgical or other therapeuthic interventions. However, the evidence base for this statement is unclear. At the University Rehabilitation Institute Ljubljana, we implemented nationwide rehabilitation programme for persons after primary treatment of malignant and non-malignant brain tumours. The inclusion criteria for the programme is functional status described as 50 or more points according to Karnofsky scale and functionality deficits of the patient which demand a comprehensive, interdisciplinary and multiprofessional interventions.
SUBJECTS AND METHODS: Medical files of 14 persons admitted for inpatient rehabilitation after primary therapy with non malignant tumours and 18 persons with malignant tumours were reviewed. The primary parameters of observation were initial and discharge functional status with Functional Independece Measure (FIM) scale and Karnofsky performance scale, length of stay and location of discharge. We compared the parameters for patients in both groups. Study was approved by the hospital´s ethical committee.
RESULTS: The most frequent types of tumour in group with non malignant tumour were meningeoma, pinealoma and epemdimoma. Most frequent types of tumour in group with malignant tumour were glioblastoma, astrocitoma and glioma. Patients with malignant tumours were admitted to rehabilitation in shorter time after beginning of disease then those with non malignant tumours (17.7 months vs. 25.4 months). There was not significant difference between groups in assesment on Karnofsky performance scale (55.0 vs. 57.4). The non malignant tumours group had significantly better income / outcome score on FIM scale against group with malignant tumours (79.8 points / 94.6 points vs. 70.6 points / 75.5 points). Patients with malignant tumours were hospitalized significantly less time than patients with non malignant tumours (24.5 days vs. 38.6 days). All patients with non malignant tumours were discharged home without complications during rehabilitation. In group with malignant tumour 2 / 18 persons were transferred back to acute department due to complications.
CONCLUSION: Althought there was no difference in Karnofsky scale assesment between both groups, the functional assesment of burden of care with FIM scale revealed an important difference between groups. The assesment of functional status before and after rehabilitation programme indicates worse rehabilitation potential in persons with malignant tumours. Rehabilitation goals of patients are adapted individually to a realistic level which is generally lower for patients with malignant tumours. Therefore their goals are achievable in a shorter period of time what explains faster discharge of patients group with malignant tumours.