OBJECTIVE: To confirm functional improvement in brain tumor patients after 4-week conventional rehabilitation therapy, to compare the cognitive impairment of brain tumor patients with subacute stroke patients using computerized neuropsychological testing, and to determine the effects on functional outcomes of daily activity. METHODS: From April 2008 to December 2012, 55 patients (29 brain tumor patients and 26 subacute stroke patients) were enrolled. All patients were assessed with a computerized neuropsychological test at baseline. Motricity Index, Korean version of Mini Mental Status Examination, and Korean version of Modified Barthel Index scores were assessed at the beginning and end of 4-week rehabilitation. Conventional rehabilitation therapy was applied to both groups for 4 weeks. RESULTS: Functional outcomes of all patients in both groups significantly improved after 4-week rehabilitation therapy. In brain tumor patients, the initial Motricity Index, cognitive dysfunction, and visual continuous performance test correction numbers were strong predictors of initial daily activity function (R2=0.778, p<0.01). The final Motricity Index and word-black test were strong predictors of final daily activity function (R2=0.630, p<0.01). In patients with subacute stroke, the initial Motricity index was an independent predictor of initial daily activity function (R2=0.245, p=0.007). The initial daily activity function and color of color word test were strong predictors of final daily activity function (R2=0.745, p<0.01). CONCLUSION: Conventional rehabilitation therapy induced functional improvement in brain tumor patients. Objective evaluation of cognitive function and comprehensive rehabilitation including focused cognitive training should be performed in brain tumor patients for improving their daily activity function.
Brain Neoplasms* ; Brain* ; Humans ; Neuropsychological Tests ; Rehabilitation* ; Stroke*

The objective of this study is to investigate the short-term effects of intensive inpatient rehabilitation in patients with brain tumor. Retrospective data from September 2015 to May 2017 was obtained in 65 patients with brain tumor who were transferred to the department of physical and rehabilitation medicine for comprehensive intensive inpatient rehabilitation. For comparison, data from 140 patients with subacute stroke were also obtained. To measure functional status, we collected data from the following tests: the Korean version of the Modified Barthel Index, the Motricity Index, the Korean Mini-Mental Status Examination, and the Functional Ambulatory Category. Functional efficiency of each assessment was calculated as the gain divided by the inpatient rehabilitation length of stay. Independent t-test was performed to compare functional outcomes between the brain tumor group and the subacute stroke group. There were significant improvements in all functional assessments in both the brain tumor group and the subacute stroke group (p < 0.05). In addition, there was no significant difference in the functional gain and efficiency in all assessments between the 2 groups. The results of the present study revealed that intensive inpatient rehabilitation could have potential to improve the functional levels in patients with brain tumor.
Brain Neoplasms* ; Brain* ; Humans ; Inpatients* ; Length of Stay ; Physical and Rehabilitation Medicine ; Rehabilitation* ; Retrospective Studies ; Stroke

This first annual report provides a description of patients discharged from rehabilitation facilities in Korea based on secondary data analysis of Korean Brain Rehabilitation Registry V1.0 subscribed in 2009. The analysis included 1,697 records of patients with brain disorders including stroke, traumatic brain injury, brain tumor and other disorders from 24 rehabilitation facilities across Korea. The data comprised 1,380 cases of stroke, 104 cases of brain injury, 55 cases of brain tumor, and 58 cases of other brain diseases. The functional status of each patient was measured using the Korean version of the Modified Barthel Index (KMBI). The average change in the KMBI score was 15.9 for all patients in the inpatient rehabilitation facility. The average length of stay for inpatient rehabilitation was 36.9 days. The transfer rates to other hospitals were high, being 62.4% when all patients were considered. Patients with brain disorders of Korea in 2009 and measurable functional improvement was observed in patients. However, relatively high percentages of patients were not discharged to the community after inpatient rehabilitation. Based on the results of this study, consecutive reports of the status of rehabilitation need to be conducted in order to provide useful information to many practitioners.
Adult ; Aged ; Brain Diseases/*rehabilitation ; Brain Injuries/rehabilitation ; Brain Neoplasms/rehabilitation ; *Disability Evaluation ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Registries ; Rehabilitation Centers ; Republic of Korea ; Stroke/rehabilitation

Robot-assisted gait training (RAGT) is beneficial in effectively implementing repetitive, high-intensity gait training. Several studies have been conducted in different fields of RAGT; however, only a few have explored such training practices in patients with brain tumors. We conducted RAGT in 3 patients with primary brain tumors. They were treated with 30 minutes of Morning Walk® training, followed by 1 hour of conventional physiotherapy, 5 times a week for 3 weeks. At the end of RAGT, the outcomes revealed improved scores in all 3 patients on several assessments, such as the 10-meter walk test, Modified Barthel Index, Rivermead Mobility Index, Berg Balance Scale, and Karnofsky Performance Status Scale. However, the level of fatigue (Brief Fatigue Index) increased in all the patients. RAGT accompanied with conventional physiotherapy is beneficial for gait speed, mobility, and functional ambulation, but the level of fatigue is deteriorated at the same time in patients with brain tumors. The time, intensity, and protocol of RAGT accompanied with conventional physiotherapy need to be tailored to the level of fatigue expressed by patients with brain tumors to improving gait disturbances effectively.
Brain Neoplasms* ; Brain* ; Fatigue ; Gait* ; Humans ; Karnofsky Performance Status ; Rehabilitation ; Walking

PURPOSE: The purpose of this study was to assess clinical practice and barriers associated with cancer rehabilitation from the perspective of Korean physiatrists. MATERIALS AND METHODS: All active members of the Korean Academy of Rehabilitation Medicine were invited to complete an online survey developed after focus group discussions. RESULTS: A total of 97 physiatrists (72 males and 25 females) in Korea completed the survey. Of these, 77% reported familiarity with the term 'cancer survivors.' More than 50% of respondents reported that they provided rehabilitation services for patients with breast cancer (61.9%), brain tumors (64.9%), and spinal tumors (63.9%), whereas 86.6% of respondents reported that they had never or rarely provided rehabilitation programs for patients with gynecological, colorectal, or prostate cancer. Physiatrists who received referrals from a well-organized cooperative referral system reported providing services such as exercise programs for patients with gynecological cancer (odds ratio [OR], 2.16; p=0.044) as well as education regarding lymphedema (OR, 1.81; p=0.047) and neuropathic pain (OR, 1.96; p=0.026). CONCLUSION: Although most of the physiatrists surveyed believed that they should contribute to the management of cancer patients, they considered themselves ill equipped to provide appropriate rehabilitation services. This lack of understanding of the effectiveness of rehabilitation services for cancer patients and absence of a cooperative referral system are the major barriers to providing rehabilitation services to cancer survivors in Korea.
Brain Neoplasms ; Breast Neoplasms ; Data Collection ; Education ; Focus Groups ; Humans ; Korea ; Lymphedema ; Male ; Neuralgia ; Physical and Rehabilitation Medicine ; Professional Practice ; Prostatic Neoplasms ; Recognition (Psychology) ; Referral and Consultation ; Rehabilitation* ; Survivors

OBJECTIVE: To evaluate the effectiveness of intensive rehabilitation to support recovery of neurological function after brain tumor surgery and assess long-term satisfaction. METHODS: This retrospective study included patients with neurological impairment after brain tumor surgery who underwent intensive rehabilitation therapy between December 2013 and May 2017. To assess effectiveness of rehabilitation, functional outcomes (motor, cognition, and activities of daily living [ADL]) were compared between brain tumor group and a control group enrolling stroke patients who received equivalent rehabilitation during the study period. Long-term satisfaction with rehabilitation was evaluated by surveying family caregivers. RESULTS: This study included 21 patients with benign brain tumor, 14 with malignant brain tumor, and 108 with stroke. Significant and similar improvement in motor, cognition, and ADL function were noted in both the brain tumor group and the stroke group. Malignancy status did not influence the extent of functional improvement. According to medical records and surveys, 9 (69.2%) patients with malignant tumor and 2 (11.8%) with benign tumor had expired by the time of the survey. Most family caregivers confirmed that rehabilitation was effective for functional improvement (>60%), expressing overall satisfaction and stating they would recommend such therapy to patients with similar conditions (approximately 70%). CONCLUSION: Intensive rehabilitation may help promote functional improvement following brain tumor surgery regardless of malignancy compared with stroke patients. Family caregivers expressed overall satisfaction with rehabilitation at long-term follow-up. These findings support the provision of intensive rehabilitation therapy for neurologic function recovery following brain tumor surgery.
Activities of Daily Living ; Brain Neoplasms ; Brain ; Caregivers ; Cognition ; Follow-Up Studies ; Humans ; Medical Records ; Neurological Rehabilitation ; Pilot Projects ; Recovery of Function ; Rehabilitation ; Retrospective Studies ; Stroke ; Treatment Outcome

We experienced a patient who developed a cerebral air embolism after subclavian venous catheter removal. The patient underwent gastric antrectomy under impression of gastric cancer. After surgery, right subclavian venous catheter was removed while the patient was kept in supine position for 15 minutes. When he changed to sitting position, he became agitated and O2 saturation was dropped to 72%. Im-mediately 100% O2 was administered via air mask. Computed tomography of brain showed multiple focal air densities in the cerebral vessels. Three days after the event, he slowly regained consciousness with persistent left hemipareis. After rehabilitation, he was able to walk with quadcane and gained functional improvement.
Brain ; Catheters* ; Consciousness ; Dihydroergotamine ; Embolism, Air* ; Embolism, Paradoxical ; Humans ; Masks ; Rehabilitation ; Stomach Neoplasms ; Supine Position

OBJECTIVE: To investigate whether virtual reality (VR) training will help the recovery of cognitive function in brain tumor patients. METHODS: Thirty-eight brain tumor patients (19 men and 19 women) with cognitive impairment recruited for this study were assigned to either VR group (n=19, IREX system) or control group (n=19). Both VR training (30 minutes a day for 3 times a week) and computer-based cognitive rehabilitation program (30 minutes a day for 2 times) for 4 weeks were given to the VR group. The control group was given only the computer-based cognitive rehabilitation program (30 minutes a day for 5 days a week) for 4 weeks. Computerized neuropsychological tests (CNTs), Korean version of Mini-Mental Status Examination (K-MMSE), and Korean version of Modified Barthel Index (K-MBI) were used to evaluate cognitive function and functional status. RESULTS: The VR group showed improvements in the K-MMSE, visual and auditory continuous performance tests (CPTs), forward and backward digit span tests (DSTs), forward and backward visual span test (VSTs), visual and verbal learning tests, Trail Making Test type A (TMT-A), and K-MBI. The VR group showed significantly (p<0.05) better improvements than the control group in visual and auditory CPTs, backward DST and VST, and TMT-A after treatment. CONCLUSION: VR training can have beneficial effects on cognitive improvement when it is combined with computer-assisted cognitive rehabilitation. Further randomized controlled studies with large samples according to brain tumor type and location are needed to investigate how VR training improves cognitive impairment.
Brain Neoplasms* ; Cognition ; Humans ; Male ; Neuropsychological Tests ; Rehabilitation ; Trail Making Test ; Verbal Learning ; Virtual Reality Exposure Therapy

OBJECTIVE: To identify and evaluate the outcome of consultation base rehabilitatiion program and the site of primary lesions of the hospitalized cancer patients. METHOD: Medical records of 119 hospitalized patients with cancer who received the consultation base rehabilitation program from January 1999 to December 2000, were reviewed. Karnofsky Performance Status scale (KPSS) was used as a functional measurement. RESULT: The most common primary cancer referred for the consultation base rehabilitation program was a lung cancer (16.8%), followed by brain cancer (10.9%) and hepatic cancer (9.2%). Spine was the most common metastatic site (72.7%). Strengthening (47.2%) and range of motion exercises (39.6%) were commonly prescribed rehabilitative procedures in the cancer patients with no metastasis and bracing (45.5%) was the most common cause for consultation in the cancer patients with metastasis. A significant functional improvement was observed between the initial (mean=58.4%) and final assessments (mean=65.2%) on KPSS (p<0.01) in the cancer patients with no metastasis. However, the cancer patients with metastasis did not show a significant functional improvement. CONCLUSION: Significant functional gains were observed in cancer patients who received the consultation base rehabilitation program.
Braces ; Brain Neoplasms ; Exercise ; Humans ; Karnofsky Performance Status ; Liver Neoplasms ; Lung Neoplasms ; Medical Records ; Neoplasm Metastasis ; Range of Motion, Articular ; Rehabilitation* ; Spine

Bilateral thalamic gliomas (BTGs) are rare brain tumors. In general, the prognosis is poor because of the involvement of bilateral thalami and limitations of surgical excision. Consequently, patients with symptoms of personality changes and memory impairment must be differentiated from others. Magnetic resonance imaging (MRI) is essential for the diagnosis of BTGs and reveals a hypo-intense lesion on T1-weighted images and a hyper-intense lesion on T2 images. We report a case of a 17-year-old female patient suffering from progressive cognitive dysfunction and personality changes and subsequent rehabilitation treatment. Brain MRI showed an enlarged bilateral thalamus, with hyperintensity on T2-weighted images and iso-intensity on T1-weighted images. A biopsy was performed, and the pathology revealed a high-grade glioma. The patient was referred for radiotherapy and chemotherapy. She also underwent rehabilitation treatment for 5 weeks and showed improvement in standing balance, endurance, and speech fluency. The patient's Modified Barthel Index scores also improved. Cancer rehabilitation is important in brain tumor patients because they have a higher incidence of neurological sequelae than others. Rehabilitation of patients with a malignant brain tumor is also important for improving health-related quality of life by maintaining the general condition and preventing complications during and after cancer treatment.
Adolescent ; Biopsy ; Brain ; Brain Neoplasms ; Diagnosis ; Drug Therapy ; Female ; Glioma ; Humans ; Incidence ; Magnetic Resonance Imaging ; Memory ; Memory Disorders ; Neurobehavioral Manifestations ; Pathology ; Prognosis ; Quality of Life ; Radiotherapy ; Rehabilitation ; Thalamus