RESUMEN
Glioblastoma multiforme (GBM) is the most common and aggressive brain tumor. To identify the factors influencing the improvement of the activities of daily living (ADL) in newly diagnosed patients with GBM, we investigated the characteristics and variable factors and overall survival. A total of 105 patients with GBM were retrospectively analyzed and categorized into the following three groups according to the quartile of change of their Barthel index score from admission to discharge: deterioration (n = 25), no remarkable change (n = 55), and good recovery (n = 25). A statistical difference was observed in the pre-operative, intra-operative, post-operative, and rehabilitation-related factors between the deterioration and good recovery groups. Multiple regression analysis identified the following significant factors that may influence the improvement of ADL after surgery: the improvement of motor paralysis after surgery, mild fatigue during radio and chemotherapy, and length up to early walking training onset. The median overall survival was significantly different between the deterioration (10.6 months) and good recovery groups (18.9 months, p = 0.025). Our findings identified several factors that may be associated with post-operative functional improvement in patients with GBM. The inpatient rehabilitation during radio and chemotherapy may be encouraged without severe adverse events and can promote functional outcomes, which may contribute to the overall survival of newly diagnosed patients with GBM.
RESUMEN
AIM: To promote preventive care among older individuals dwelling on an isolated, doctor-less island, we investigated the feasibility and the efficacy of a home-based exercise program, depending on their functional status and health-related quality of life. METHODS: A total of 23 older (mean age 72.6 years) participants were assigned to a home-based exercise program (intervention group), and 34 older (mean age 74.2 years) participants were assigned to a group without any intervention (control group). The participants of the intervention group attended the exercise program three times a week for 3 months. The exercise program consisted of various exercises involving stretching, muscle strengthening, balance retraining and walking. The physical performance, Functional Independence Measure and Short-Form 36-item health survey were used to assess the physical and the mental wellbeing of the participants. RESULTS: There was no significant difference between the changes in physical performance at baseline and post 3 months in both groups. However, the motor and the cognitive Functional Independence Measure scores significantly improved in the intervention group post 3 months. The domains of the Short-Form 36-item health survey improved post 3 months; particularly, significant improvement was observed in the physical functions, general health, vitality, mental health and mental component summary. CONCLUSIONS: Although an isolated island has several problems to support preventive care services, such as a lack of medical resources and availability of only a few healthcare workers, the present study provides evidence on the feasibility and efficacy of nurse-led home-based exercise programs for improving the physical and mental health of the older people dwelling on an isolated, doctor-less island. Geriatr Gerontol Int 2018; 18: 1313-1317.