Recovery in glioblastoma multiforme during inpatient rehabilitation is equivalent in first versus repeat resection: A 10-year retrospective analysis

Age-independent benefits of postoperative rehabilitation during chemoradiotherapy on functional outcomes and survival in patients with glioblastoma

PURPOSE

To investigate the impact of early and continuous postoperative inpatient rehabilitation during chemoradiotherapy on functional outcomes and overall survival (OS) in patients with glioblastoma (GBM), particularly in different age groups.

METHODS

This retrospective cohort study at a university hospital (2011-2016) included 75 of 119 consecutive patients newly diagnosed with GBM who underwent standardized treatment and postoperative rehabilitation. Patients were divided into older (≥ 65 years, n = 45) and younger (< 65 years, n = 30) groups, engaging in a 50-day rehabilitation program. We assessed rehabilitation progress, Barthel Index (BI), Brunnstrom Recovery Stage (BRS), adverse events, and OS. BI at discharge and survival were analyzed using multivariate and Cox regression models, respectively.

RESULTS

The mean age was 72.5 ± 6.3 and 52.4 ± 7.8 years in the older and younger groups, respectively. Both groups demonstrated significant improvements in BI and BRS. Despite more adverse events in the older group, no significant difference existed in median OS (older group: 18.7 months vs. younger group: 18.3 months, p = 0.87). Early walking training, reduced fatigue during chemoradiotherapy, and high Karnofsky Performance Status at admission significantly impacted the BI at discharge. Cox regression analysis identified the BI at discharge as a significant predictor of survival (hazard ratio [HR] 0.98, 95% confidence interval [CI] 0.97-0.99, p = 0.008).

CONCLUSION

Integrated rehabilitation improves functional outcomes, and enhanced ADL at discharge is associated with improved survival outcomes in patients with GBM, regardless of age. This highlights the need for personalized rehabilitation in treatment protocols. Further prospective studies are warranted to confirm these findings.

Post-acute Care Needs and Benefits of Inpatient Rehabilitation Care for the Oncology Patient

PURPOSE OF REVIEW

This study aims to assess recent literature published on the post-acute care needs of cancer patients, specifically focusing on the acute inpatient rehabilitation setting.

RECENT FINDINGS

The neurologic cancer population appears to be the most studied oncologic population in acute inpatient rehabilitation studies within the past 5 years. This finding is consistent with prior findings from the past several decades. Recent trends in inpatient cancer rehabilitation note a population with lower admission functional status and shorter lengths of stay compared to prior studies. Despite these findings, the percentage discharged to the community remains high. With new treatments yielding improved survival, cancer patients may live longer and risk accumulating more functional impairments. Physicians involved in their care must understand post-acute care needs and work in a multidisciplinary group to best determine post-acute disposition. This decision remains very individualized and should consider both oncologic and functional needs.

Frequency and reasons for unplanned transfer to the primary acute care service of inpatient rehabilitation glioblastoma multiforme patients

PURPOSE

To determine the percentage of and factors associated with unplanned transfer to the acute care service of glioblastoma multiforme acute rehabilitation inpatients.

METHODS

Retrospective review of glioblastoma multiforme acute rehabilitation inpatients admitted 4/1/2016-3/31/2020 at a National Cancer Institute Comprehensive Cancer Center.

RESULTS

One hundred thirty-nine consecutive admissions of unique glioblastoma multiforme acute rehabilitation inpatients were analyzed. Fifteen patients (10.7%, 95% confidence interval 6.5-17.1%) were transferred to the acute care service for unplanned reasons. The most common reasons for transfer back were neurosurgical complication 6/15(40%), neurologic decline due to mass effect 4/15(26.7%), and pulmonary embolism 2/15(13.3%). Older age (p = 0.010), infection prior to acute inpatient rehabilitation transfer (p = 0.020), and lower activity measure of post-acute care 6-click basic mobility scores (p = 0.048) were significantly associated with transfer to the acute care service. Patients who transferred to the acute care service had significantly lower overall survival than patients who did not transfer off (log-rank test p = 0.001).

CONCLUSION

Acute inpatient physiatrists should closely monitor patients for neurosurgical and neurologic complications. The variables significantly associated with transfer to the acute care service may help identify patients at increased risk for medical complications who may require closer observation.

Feedforward Control Combined with 4F Management on Postoperative Nursing Effects and Motor Function of Meniscus Sports Injuries: Based on a Prospective Case Analysis

Background

Because active functional training and management after knee cartilage sports injury is the key to treatment, care of patients after an operation with knee cartilage sports injury is critical.

Aims

To explore the effect of feedforward control combined with 4F management and after an operation nursing effect on patients with knee cartilage sports injury.

Materials and Methods

According to the random number table method, 100 patients with knee cartilage sports injury who were nursed in our hospital from June 2019 to June 2021 were selected as the research objects and divided into the control group and the instance of watching, noticing, or making a statement group with 50 cases in each group according to the different nursing order. Among them, the control group adopted 4F management combined with feedforward control nursing mode: all-weather, whole-process, whole-system, and all-around services for patients. On this basis, the instance of watching, noticing, or making a statement group cooperated with early healing/repairing training to compare fear and stress-related self-test of the two groups of patients after an operation. Knee function and quality of care are scored using tables.

Results

After nursing, the knee joint function score of the instance of watching, noticing, or making a statement group was higher than that of the control group, while the pain after the operation, sleep quality, fear, and stress self-rating scale scores were significantly lower than the control group (P < 0.05). The whole-process management, body position placement, risk evaluation, repairing training, all-weather service, whole-system management, and comprehensive service of the two groups of patients were very much improved. The nursing quality of watching, noticing, or making a statement group was significantly higher than the control group (P < 0.05).

Conclusion

Feedforward control combined with 4F management combined with early repairing training can effectively reduce the fear and stress after an operation pain and sleep quality of knee cartilage sports injury and help increase the recovery of knee combined function in a good way.