Optimizing post-acute care inpatient rehabilitation for patients with brain metastasis: A systematic review of functional outcomes.

Purpose: This study aimed to provide insight into optimizing inpatient rehabilitation (IR) for patients with brain metastases (BM) following hospitalization, including exploring functional outcomes and reviewing interdisciplinary considerations.

Methods: Using PRISMA guidelines, a search of PubMed and Embase was conducted to identify studies demonstrating functional outcomes of IR for patients with brain metastases.

Results: Three studies met inclusion criteria and a total of 59 patients with brain metastasis underwent IR. The median length of IR was 19.2 days (range: 17.95 - 20). Discharge destination after IR is available for 39 patients, including 33 (84.6%) who were discharged home, 1 (2.6%) who was discharged to a long-term care facility, 3 (7.7%) to an acute care ward, and 2 (5.1%) to palliative care. All 3 studies (n=59) used the Functional Independence Measure (FIM) to assess function after IR. The weighted average total FIM percent gain between admission and discharge was 14.9% (range: 9.6% - 27.4%) and the average FIM efficiency was 0.61 (range: 0.45 - 0.94). For the 2 studies (n=46) that reported motor and cognitive FIM, the weighted average motor gain (16.5%) was greater than the cognitive gain (3.6%).

Conclusion: Inpatient rehabilitation (IR) may enhance functional status and independence in patients with brain metastases during the interim post-hospitalization period, optimizing functional performance for a smoother transition to subsequent oncologic treatments. Healthcare providers within the multidisciplinary team should optimize the post-acute hospitalization period by considering both functional status and oncologic prognosis in patients with brain metastases to streamline rehabilitation efforts and minimize delays in oncologic care.