Sherer, M., Meyers, C.A., & Bergloff, P. (1997). Efficacy of postacute brain injury rehabilitation for patients with primary malignant brain tumors. Cancer, 80, 250–257.

The study was conducted to determine

• Whether patients with brain tumors could benefit from rehabilitative interventions already shown to be effective for patients with traumatic brain injury (TBI)
• Whether the resources expended on the rehabilitation of patients with brain tumors compare favorably with those expended on patients with head trauma
• Whether the benefits gained would suggest that the availability of such services on a broader scale should be encouraged.

Interventions were individualized after initial evaluation of each participant’s cognitive, behavioral, affective, and social functioning. This initial evaluation included an interview with the participant and at least one significant other. In some cases, home visits or observations of the participant in a community setting (e.g., work site) were performed.

Interventions were provided by various professionals (e.g., psychologists, speech pathologists, occupational therapists, and vocational specialists). Therapy was conducted in both individual and group settings, with a typical therapy day lasting five hours. Participants and their significant others received concurrent education and counseling services.

Measures were taken upon admission to the program, at discharge, and at follow-up (an average of eight months after discharge).

• The number of participants was 13.
• All participants had a primary malignant brain tumor. 
• All participants underwent surgical resection and radiation therapy; 12 also received chemotherapy.
• There were 8 male and 5 female participants.
• The average participant age was 34.3 ± 10 years.
• The average years of education per participant was 15.1 ± 1.7 years.
• The average time from diagnosis to admission to program was 75.4 ± 87.9 months.
• Participants were selected retrospectively based on diagnosis and availability of adequate medical records to characterize their tumors and courses of therapy.

The study took place at the Institute for Rehabilitation and Research Challenge Program in Houston, TX. 

This was a retrospective study. 

A neuropsychological test battery was conducted, with tests for the following domains: intellectual, verbal memory, visual memory, executive functions, language, visual perception, motor, and mood. The measurement instruments were unnamed.

Independence and productivity status rating scales were completed on admission, discharge, and follow-up to the program. Rating scales were shown to be sensitive to patient improvement in previous studies of patients with TBI. Specifics include:

1. An independence rating scale ranging from maximal independence, selected monitoring, and frequent monitoring to attendant care
2. A productivity status rating scale ranging from competitive employment, a modified job, educational or vocational training, homemaker role, and avocational pursuits to non-productive status.

Improved independence for six patients and improved productivity status for eight patients was demonstrated from baseline measurements. The average cost of treatment was $5,471.19 ± $3,200.73. The average number of treatment days was 20 ± 12.85.

The study provides preliminary support for the use of treatment approaches originally designed for patients with TBI.

• The study had a small sample size, with substantial variability in participants' diseases and treatment.
• The sample may not be representative of other groups of patients with brain tumors.
• The sample was based on a referral method.
• There was a short average time from treatment to follow-up.
• Participants had varied days of treatment and treatment duration.
• Ratings of independence and productivity status were potentially subject to bias.
• The study did not evaluate the means by which the rehabilitation program improved patient functioning.