Background and Purpose:
Gliosarcoma is a highly malignant brain cancer with an exceptionally poor medical prognosis. Despite poor prognostic indicators, rehabilitation may improve quality of life and restore independence. Little research is available to guide physical rehabilitation in this population. Medical and rehabilitation prognoses are interdependent, yet distinct in terms of objective and elements of consideration.
The patient was a female in her 70s who was diagnosed with a grade IV gliosarcoma of the left frontoparietal region. The tumor was surgically resected and severe postoperative complications resulted. Following medical stabilization, she spent 2 weeks in inpatient rehabilitation, followed by 4 months of hospice care. She was discharged to skilled nursing for rehabilitation including physical, occupational, and speech-language therapy.
Multimodal rehabilitation included functional tasks, neuromotor, resistance, and gait training over 6 weeks to maximize motor function and independence.
The minimal detectable change was met or exceeded for fast gait speed, Berg Balance Scale, Timed Up and Go test, and Dynamic Gait Index. The minimal clinically important difference was exceeded for comfortable gait speed, Six-Minute Walk Test, and grip strength dynamometry. She was discharged to an assisted living facility.
Little research is available to guide intervention parameters for those with highly malignant gliomas receiving palliative care. Despite an exceptionally poor medical prognosis, skilled rehabilitation improved independence in an individual following gliosarcoma resection and should be considered for similar patients.