Factors affecting the performance of activities of daily living in patients with advanced cancer undergoing inpatient rehabilitation: results from a retrospective observational study.
Kaori Shimoda, Hisao Imai, Tetsuya Tsuji and 4 others
PMID 31645809WHAT IT FOUND
In 48 patients with advanced cancer who improved or maintained daily living skills, higher rehabilitation intensity was linked to greater gains.
Those with poor grooming ability at the start showed the most improvement. The study excluded patients who worsened, so it does not show what happens to everyone.
Key findings
01Higher rehabilitation intensity was associated with an increase in total Barthel Index score.
02Lower initial grooming scores were associated with a greater increase in total Barthel Index score.
03The study only included patients who increased or maintained their total Barthel Index score, excluding those who declined.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study only included patients who improved or maintained function, creating a selection bias that excludes those who worsened. It was a single-center retrospective design with no control group, so it cannot prove that rehabilitation caused the improvements. Rehabilitation interventions were highly variable and tailored to individual needs, making it impossible to isolate which specific treatments worked. The sample size was small (48 patients), limiting statistical power and generalizability. Therapists who provided the care also collected the data, introducing potential bias in assessments.
Declared interests
Funded by a grant from Gunma Prefectural Cancer Center, which had no influence on the study design, analysis, or presentation. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that higher rehabilitation intensity causes better outcomes for all advanced cancer patients. This study only looked at those who already improved or stayed stable, excluding those who declined. The results apply only to patients who tolerate and benefit from rehab, not to those who worsen during treatment.