Efficacy of postacute brain injury rehabilitation for patients with primary malignant brain tumors

BACKGROUND. Patients with primary malignant brain tumors (PMBT) often have neurobehavioral deficits due to the tumor, subsequent surgery, and therapies that interfere with their ability to live independently or work. Previous studies have shown that such patients generally have a progressive decline in functioning from diagnosis to death. Consequently, PMBT patients have not been considered good candidates for rehabilitation services. The current study is a preliminary, retrospective investigation of the effectiveness of postacute brain injury rehabilitation methods, originally developed for traumatic brain injury survivors, in a sample of patients with PMBT. METHODS. The subjects were 13 patients with a history of surgical resection of PMBT and subsequent radiation and chemotherapy. There were 8 males and 5 females with a mean age of 34.3 +/- 10.0 years and a mean educational level of 15.1 +/- 1.7 years. Mean time from tumor diagnosis to the commencement of rehabilitation was 75.4 +/- 87.9 months. All patients had cognitive deficits documented with neuropsychologic tests. Patients received an average of 2.6 +/- 1.9 months of postacute brain injury rehabilitation. RESULTS. Six patients had increased independence during the time from the start of rehabilitation to discharge, six were unchanged, and one patient had decreased independence. Eight patients had increased productivity during the same time period, four were unchanged, and one had decreased productivity. Treatment gains were maintained at follow-up 8.0 +/- 7.6 months after discharge. CONCLUSIONS. The results of the current study offer preliminary support for the effectiveness of postacute brain injury rehabilitation in the management of PMBT patients. Although additional investigation is needed, such treatment appears to be an attractive, relatively low cost option for these patients. (C) 1997 American Cancer Society.