Effectiveness of Physical Therapy--and Occupational Therapy--Based Rehabilitation in People Who Have Glioma and Are Undergoing Active Anticancer Treatment: Single-Blind, Randomized Controlled Trial

Background. It is recommended that people with gliomas engage in rehabilitation, but high-quality evidence to support this recommendation is lacking. Objective. This study assesses the effectiveness of a physical therapy--and occupational therapy--based rehabilitation intervention compared with usual rehabilitation care for quality of life (QoL) during active anticancer treatment. Design. This study was a randomized controlled trial. Setting. The study took place in Odense University Hospital, Denmark. Participants. The trial included people with gliomas who were functionally independent. Intervention. The participants were randomly assigned to a supervised rehabilitation intervention or usual rehabilitation care during the active anticancer period. The supervised rehabilitation included physical therapy and occupational therapy-based interventions. Measurements. The primary outcome was the between-group difference in the overall QoL from baseline to the 6-week follow-up. It was self-rated with the global health status (GHS)/QoL domains from the European Organization for Research and Treatment of Cancer Questionnaire. Eighty-eight participants per group were required to find a 10% between-group difference from baseline to the 6-week follow-up. Secondary outcomes were the health-related QoL domains, symptomatology, and functional performance. Results. A total of 64 participants were included (32 in the intervention group and 32 in the control group). At follow-up, the intervention group self-rated a nonsignificantly better score for GHS/QoL than the control group (adjusted mean difference = 8.7% [95% confidence interval = -4.36 to 21.79]). Compared with the control group, the intervention group had consistently better results on self-rated secondary outcomes, including cognitive functioning ([beta] = 16.2) and fatigue ([beta] = -13.4), and objectively measured aerobic power ([beta] = 2.6). Limitations. The number of participants and duration of follow-up were inadequate to determine if the intervention was superior to the current usual rehabilitation care. Conclusions. The physical therapy--and occupational therapy--based rehabilitation intervention did not affect GHS/QoL. However, the trial found promising significant effects on both objective and self-reported secondary outcomes, making rehabilitation efforts during active anticancer treatment promising.
Gliomas, also known as World Health Organization grade I to IV glial cell brain tumors, (1) are among the most devastating cancer diseases affecting humans. Poor prognosis and adverse effects [...]