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

Abstract

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 (β = 16.2) and fatigue (β =-13.4), and objectively measured aerobic power (β = 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.