Effectiveness of integrated multidisciplinary rehabilitation in primary brain cancer survivors in an Australian community cohort: a controlled clinical trial

Objective: To evaluate effectiveness of a multidisciplinary rehabilitation program for persons following definitive primary brain tumour treatment in a community cohort. Methods: The brain tumour (glioma) survivors (n = 106) were allocated either to the treatment group (n = 53) (intensive ambulatory multidisciplinary rehabilitation), or the waitlist control group (n = 53). The primary outcome ? Functional Independence Measure (FIM), measured `Activity? limitation; secondary measures included Depression, Anxiety Stress Scale, Perceived Impact Problem Profile and Cancer Rehabilitation Evaluation System. Assessments were at baseline, 3 and 6 months after program completion. Results: Participants were predominantly women (56 ), with mean age 51 years (standard deviation 13.6) and median time since diagnosis of 2.1 years. Intention-to-treat analysis showed a significant difference between groups at 3-month in favour of multidisciplinary rehabilitation program in FIM motor subscales: `self-care?, `sphincter?, `locomotion?, `mobility?(p <0.01 for all); and FIM `communication? (p <0.01) and `psychosocial? subscales (p <0.05), with small to moderate effect size (r = 0.2?0.4). At 6-month follow-up, significant improvement in the treatment group was maintained only for FIM `sphincter?, `communication? and `cognition? subscales (p <0.01 for all). No difference between groups was noted in other subscales. Conclusions: brain tumour survivors can improve function with multidisciplinary rehabilitation, with some gains maintained up to 6 months. Evidence for specific interventions in the `blackbox? of rehabilitation is needed.