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
2020
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.
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