Effectiveness of a personalized rehabilitation reconditioning program in brain tumors
Dr Nathalie KHALILa, Mrs Laurie LEYES-BRETa, Dr Dominique MARCONa, Mrs Marie-Frédérique FERRYa, Dr Marie BLONSKIb, Dr Mathias POUSSELc, Prof Bruno CHENUELc, Prof Luc TAILLANDIERb, Prof Jean PAYSANTa
a Institut Régional de Réadaptation de Nancy, b Service de neuro-oncologie, CHU Nancy, c Service d'Epreuves Fonctionnelles Respiratoires, CHU Nancy
Objective: Exercise behavior has shown its interest in cancers and may have a prognosis value in brain tumors (1). The aim of this prospective study is to show the effectiveness of a guided personalized rehabilitation reconditioning program in brain tumors.
Patients: Inclusion criteria: patients over 18; complain of fatigue and decrease or interruption of a physical activity; histological diagnosis of brain tumor; Karnofsky Performance Status > 60. Exclusion criteria: major neurological or cognitive impairment; cardiac or pulmonary contraindication; high risk of tumor progression.
Methods: Patients underwent an incremental, physician-supervised cardiopulmonary exercise test (CPET) before including the personalized rehabilitation reconditioning program. The program included 5 to 10 individualized sessions, supervised by a physiotherapist; from 30 to 45 minutes per session; 1 to 2 times per week; alterned or continuous on walking treadmill or bicycle. The endurance phase was calculated depending on results of the CPET. The objectives of the sessions were personalized; the physical therapist gave the patient therapeutic advices to continue physical activity after the reconditioning program, with a written notebook of follow-up for self- sessions provided at home. The primary outcome was a 6-minute walk test (6MWT) (2).
Results: 19 patients, mean aged of 53 years old (standard deviation 14.2) were proposed by the neurologist to follow the program; 11 had high-grade glioma and 8 of them low-grade glioma. 14 patients were included; 9 completed the program, 3 are currently following it. At follow up, all patients who had completed the program increased their walking speed from 1.68 m/sec (6 km/h) to 1.92 m/sec (6.9 km/h) (p= 0.022).
Discussion: Brain tumor survivors can improve walking function after a personalized and guided rehabilitation reconditioning program. This study is a preliminary study before a controlled study measuring the effects of such a program on quality of life and survey in glioblastoma.
References: (1) Ruden E and al, J Clin Oncol 2011 (2) ATS Statement: Guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002
Keywords : cardiorespiratory rehabilitation, brain tumour, glioma, physical activity, walking speed