Functional outcomes and quality of life in patients with brain tumors: A preliminary report

Objectives: To determine the relationship between functional outcome and quality of life (QOL) in patients with brain tumors receiving inpatient rehabilitation, and to assess the sensitivity of 4 assessment tools in measuring changes in that population. Design: Prospective study using longitudinal data collected from consecutively admitted patients. Setting: Acute inpatient rehabilitation unit. Participants: Ten patients with primary brain tumors admitted to an acute inpatient rehabilitation unit. Interventions: Patients participated in an inpatient interdisciplinary rehabilitation program that used the following disciplines: occupational therapy, rehabilitation therapy, recreational therapy, speech therapy, physical therapy, rehabilitation nursing and case management. Main Outcome Measures: The FIM™ instrument, Disability Rating Scale (DRS), Karnofsky Performance Status Scale (KPS), Functional Assessment of Cancer Therapy - Brain (FACT-BR). Results: Improvement in total functional outcome was indicated by all 3 functional measures (FIM: F = 46.84, p <.05; DRS: F = 19.25, p <.05; KPS: F = 10.11, p <.05). Significant improvements were found between admission and discharge scores for the FIM and DRS. The KPS revealed significant improvement between admission and 3-month follow-up scores. All admission and discharge functional scales (FIM, DRS, KPS) correlated significantly with each other. No significant change was noted in the FACT-BR between admission and discharge scores, but FACT-BR scores did improve at 1- and 3-months postdischarge relative to admission. The FIM, KPS, and DRS did not show significant correlation with the FACT-BR. Ninety percent of patients were initially discharged to a home environment. Conclusion: Although patients make functional gains during and after inpatient rehabilitation, gains in QOL are not significant until 1 month postdischarge. QOL does not appear to correlate well with functional outcomes. Further, the KPS is less sensitive than the FIM and DRS in detecting change in functional status.