Functional outcomes of persons with brain tumors after inpatient rehabilitation

Objective: To assess the extent of functional gains measured before and after inpatient rehabilitation in patients who have primary or metastatic brain tumors, and to identify whether the tumor type, recurrent tumor, or ongoing radiation influences outcomes. Design: Retrospective, descriptive study. Setting: A free-standing university-affiliated rehabilitation hospital. Participants: A referred sample of 132 persons, all with functional impairments from a brain tumor and discharged from inpatient rehabilitation during a 3-year time period. Intervention: Comprehensive inpatient rehabilitation. Main Outcome Measures: Functional status and rate of functional improvement (gain) as measured by the FIM™ instrument and FIM efficiency. Results: Mean FIM efficiencies ± standard deviation for motor (.82 ± .69) and cognitive (.15 ± .24) functions were equivalent across primary and metastatic tumor types (F = .42, df = 3,103, p = NS; F = .45, df = 2,104, p = NS, respectively); patients with metastatic disease had a significantly shorter length of stay at 18 ± 12.3 days (t_30.6 = 2.3, p = .03). Patients who received radiation during rehabilitation had a significantly greater (F = 4.1, df = 1,105, p < .05) motor efficiency score (1 ± .79) than those who did not (.78 ± 0.7). Patients with recurrent tumors made FIM cognitive changes equivalent to those of persons undergoing rehabilitation after their initial diagnosis, but their motor efficiency scores were significantly smaller (.55 ± .39 vs .98 ± .68, respectively) (F = 5.77, df = 1,85, p = .018), which reflected a significantly smaller FIM motor change. Conclusions: Metastatic or primary brain tumor type does not affect the efficiency of functional improvement during inpatient rehabilitation. Patients receiving concurrent radiation therapy make greater functional improvement per day than those not receiving radiation. Patients with recurrent tumors make significantly smaller functional motor gains than those completing inpatient rehabilitation after the tumor's initial diagnosis.