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.

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.

Purpose To identify pre-, intra-, and postoperative factors influencing the improvement of the activities of daily living (ADL) in newly diagnosed patients with glioblastoma (GBM), we investigated the characteristics and variable factors and overall survival. Methods A total of 105 patients with GBM were retrospectively analyzed and categorized into three groups according to the quartile of change of Barthel index score from admission to discharge: deterioration (n = 25), no remarkable change (n = 55), and good recovery (n = 25). We compared with the characteristics, variable factors, and overall survival of patients with deterioration and good recovery after tumor resection. Results There was statistically different in the pre-, intra-, and post-operative factors between the groups. Multiple regression analysis identified four significant predictor variables that may influence the improvement of ADL after surgery: the improvement of motor paralysis after surgery, mild fatigue during chemoradiotherapy, poor Karnofsky performance status at admission, and length up to early walking training onset. The median overall survival was significantly different between the patients with deterioration (10.6 months, 95% CIs, 5.19–16.00) and good recovery (18.9 months, 95% CIs, 8.61–29.18) (p = 0.025). Conclusion This study identified four factors influencing the improvement of ADL after surgery. In addition, a structured inpatient rehabilitation programs can be performed safely and improve functional outcomes, which may contribute to the survival prognosis.