Impacto de la medicina física y rehabilitación en el pronóstico funcional de los pacientes con tumor cerebral primario glial
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2018
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01/06/2017
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Universidad Complutense de Madrid
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Abstract
Los significativos adelantos médicos en el tratamiento de los tumores cerebrales primarios han dado lugar a un marcado aumento de supervivientes los cuales presentaran una alta incidencia de deficiencias relacionadas con el tumor, tanto por la evolución impredecible del mismo, como por la cirugía y efectos secundarios del tratamiento. Se necesitan estudios que exploren la efectividad en los diversos aspectos de la medicina física y rehabilitación para el manejo de la disfunción y discapacidad en los pacientes con este daño cerebral adquirido. OBJETIVOS. Analizar los resultados de la medicina física y rehabilitación (MF y RHB) inter y multidisciplinar para el pronóstico funcional de los pacientes con diagnóstico de tumor cerebral primario glial valorados por un Comité de Neurooncología durante los años 2012 a 2016, así como de las posibles variables que pueden influir en el resultado del programa de medicina física y rehabilitación y los factores con mayor valor predictivo en la calidad de vida percibida por el paciente y su cuidador principal. MATERIAL Y MÉTODOS. Se revisan 372 pacientes valorados en sesión clínica por el Comité de Neurooncologìa del Hospital Clínico San Carlos desde mayo de 2012 hasta junio de 2016, de los cuales se estudian las características de los 153 diagnosticados con tumor cerebral primario glial. De los que realizaron tratamiento de MF y RHB, así como de 29 pacientes con glioma que no precisaron el mismo se realiza un estudio observacional analítico que describe el estado actual de salud percibida por el paciente y de sobrecarga del cuidador. Finalmente se completa con un estudio cuasi experimental de datos pareados (antesdespués) prospectivo histórico de 28 pacientes con glioma que han sido intervenidos y que han desarrollado el programa de MF y RHB de forma ambulante en el Servicio de MF y RHB del Hospital Clínico San Carlos de Madrid...
Significant medical achievements in the treatment of primary brain tumors have led to a noticeable increase in survivors who have a high incidence of tumor-related deficiencies, due to an unpredictable outcome of the tumour and surgery, and side effects of the treatment. Further studies are needed in order to explore the effectiveness of various aspects of physical medicine and rehabilitation, for the management of dysfunction and disability in patients with this acquired brain damage. OBJECTIVES. To analyze the results of inter- and multidisciplinary rehabilitation in the functional prognosis of patients diagnosed with primary glial brain tumor evaluated by a Committee of Neuro-Oncology during the years 2012 to 2016, as well as possible variables that may influence the outcome of the rehabilitation treatment and the factors with greater predictive value in the quality of life perceived by the patient and his / her main caregiver. MATERIAL AND METHODS. 372 patients evaluated in clinical session by the Committee of Neurooncology of San Carlos Clinical Hospital from May 2012 to June 2016 are revised, and studied 153 of them which are diagnosed of primary glial brain tumour. An observational, analytical study that describes the current state of health perceived by the patient and the overload of the caregiver in those who underwent treatment and 29 patients with glioma who were not candidates for it. Finally, it completes a quasi-experimental study before and after historical prospective data of 28 patients with glioma who have been operated on and received rehabilitative treatment on an out-patient basis at the Clinical Hospital, according to individual needs for each patient...
Significant medical achievements in the treatment of primary brain tumors have led to a noticeable increase in survivors who have a high incidence of tumor-related deficiencies, due to an unpredictable outcome of the tumour and surgery, and side effects of the treatment. Further studies are needed in order to explore the effectiveness of various aspects of physical medicine and rehabilitation, for the management of dysfunction and disability in patients with this acquired brain damage. OBJECTIVES. To analyze the results of inter- and multidisciplinary rehabilitation in the functional prognosis of patients diagnosed with primary glial brain tumor evaluated by a Committee of Neuro-Oncology during the years 2012 to 2016, as well as possible variables that may influence the outcome of the rehabilitation treatment and the factors with greater predictive value in the quality of life perceived by the patient and his / her main caregiver. MATERIAL AND METHODS. 372 patients evaluated in clinical session by the Committee of Neurooncology of San Carlos Clinical Hospital from May 2012 to June 2016 are revised, and studied 153 of them which are diagnosed of primary glial brain tumour. An observational, analytical study that describes the current state of health perceived by the patient and the overload of the caregiver in those who underwent treatment and 29 patients with glioma who were not candidates for it. Finally, it completes a quasi-experimental study before and after historical prospective data of 28 patients with glioma who have been operated on and received rehabilitative treatment on an out-patient basis at the Clinical Hospital, according to individual needs for each patient...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina Física y Rehabilitación (Hidrología Médica), leída el 01/06/2017