ФУНКЦИОНАЛЬНЫЕ ИСХОДЫ СТАЦИОНАРНОЙ НЕЙРОРЕАБИЛИТАЦИИ У ПАЦИЕНТОВ С ПЕРВИЧНЫМИ ОПУХОЛЯМИ ГОЛОВНОГО МОЗГА: КЛИНИЧЕСКИЙ ВЗГЛЯД ИЗ ПРАКТИКИ МНОГОПРОФИЛЬНОГО СТАЦИОНАРА

Abstract

Introduction. The improvement of survival in patients with primary brain tumours has led to an increase in the number of patients with pronounced and persistent functional impairments. In the clinical practice of multidisciplinary hospitals, questions of rehabilitation often remain secondary to oncological treatment, which limits the potential for functional recovery and social adaptation of patients. Aim. To assess the functional outcomes of inpatient neurorehabilitation in patients with primary brain tumours from the standpoint of real clinical practice, taking into account the patient's route and organizational constraints. Materials and methods. A clinically oriented analysis was carried out of patients with primary brain tumours who underwent a course of inpatient rehabilitation after neurosurgical and/or combined treatment. Functional condition was assessed on admission and at discharge using the Functional Independence Measure (FIM) scale. The analysis included clinical observations, the dynamics of functional status and the duration of stay in the rehabilitation department. Results. In the majority of cases a clinically significant improvement of functional status was noted by the time of discharge. The magnitude of the functional gain depended to a lesser degree on the histological type and localization of the tumour and to a greater degree on the initial level of functional independence and on the timing of the start of rehabilitation. Patients with a higher functional status on admission as a rule required a shorter duration of inpatient rehabilitation. Conclusion. Inpatient neurorehabilitation is an important component of the treatment of patients with primary brain tumours and contributes to the improvement of functional outcomes irrespective of the oncological characteristics of the tumour. The integration of rehabilitation into the early stages of the patient's route appears clinically justified and requires further development in the conditions of multidisciplinary hospitals.