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Inpatient Rehabilitation Improved Functional Status in Asthenic Patients with Solid and Hematologic Malignancies

Guo, Ying MD; Shin, Ki Y. MD; Hainley, Susan RN; Bruera, Eduardo MD; Palmer, J. Lynn PhD

American Journal of Physical Medicine & Rehabilitation: April 2011 - Volume 90 - Issue 4 - p 265-271
doi: 10.1097/PHM.0b013e3182063ba6
Original Research Articles: Cancer
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Objective: The aim of this study was to compare functional outcomes in asthenic patients with hematologic malignancies with those of asthenic patients with solid tumors after inpatient rehabilitation. We hypothesized that asthenic patients with hematologic malignancies are less likely than patients with solid tumors to make functional improvement after rehabilitation.

Design: The records of 60 asthenic cancer patients (30 consecutive patients with solid tumors and 30 consecutive patients with hematologic malignancies) who underwent inpatient rehabilitation at a comprehensive cancer center between October 2005 and October 2007 were retrospectively reviewed. Patients with focal neurologic deficits were excluded. All patients admitted to the inpatient rehabilitation unit received 3 hrs of more of therapy per weekday. The main outcomes included total, motor, and cognitive Functional Independence Measure (FIM) scores, hospital and rehabilitation length of stay, and FIM efficiency.

Results: The mean total FIM score significantly improved in patients with solid tumors (mean, 15; range, −6 to 38) and in patients with hematologic malignancies (mean, 17; range, −3 to 27); however, between-group differences in FIM scores were not significant (P = 0.31). The solid tumor patients were significantly older than the hematologic malignancy patients (71 ± 11 vs. 64 ± 12 yrs; P = 0.02), but the mean rehabilitation lengths of stay were the same for each group (9.5 days; P = 0.82). The mean FIM efficiency in the hematologic malignancy group was higher than that of the solid tumor group (1.9 vs.1.4; P = 0.049).

Conclusions: Asthenic patients with solid tumors or hematologic malignancies could benefit from inpatient rehabilitation and make significant functional gain.

From the Department of Palliative Care and Rehabilitation Medicine (YG, KYS, SH, EB) and Department of Biostatistics (JLP), The University of Texas MD Anderson Cancer Center, Houston.

All correspondence and requests for reprints should be addressed to: Ying Guo, MD, Department of Palliative Care and Rehabilitation Medicine, Unit 1414, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Supported in part by National Institutes of Health grant numbers RO1NR010162-01A1, RO1CA122292-01, and RO1CA124481-01 (to E.B.).

© 2011 Lippincott Williams & Wilkins, Inc.