QOS-11: OUTCOME OF ACUTE NEURO-REHABILITATION IN CHILDREN WITH CENTRAL NERVOUS SYSTEM (CNS) TUMOURS AND POST-OPERATIVE IMPAIRMENTS ASSESSED BY THE SOUTHAMPTON MOTOR FUNCTIONAL INDICATOR (SMFI)

Our rehabilitation service provides intensive input in the early post-operative period and during subsequent neuro-oncological treatment. We assess outcome with the SMFI which quantifies motor performance on a scale from 0 (inferior) to 15 (superior). OBJECTIVE: To compare the change in SMFI score associated with neuro-rehabilitation in neuro-oncology patients with that in children with similar deficits of other aetiologies. METHOD: SMFI scores were prospectively collected in 107 children: 17 children (10 post-operative hemiplegia, 7 posterior fossa syndrome) with acute neurological impairments due to brain tumours; and 90 children (25 stroke, 65 traumatic brain injury) with acquired brain injury of other aetiologies but similar motor presentation. RESULTS: Nine (90%) post-operative hemiplegia patients showed improved SMFI scores at discharge, median change 8.5 points (range 0-15); one (10%) improved to 15 (i.e. ceiling). Seven (100%) posterior fossa syndrome patients showed improved scores at discharge, median change 9.5 (range 1-12); one (14%) scored 15. Twenty four (96%) stroke patients showed improvement; median change 9.3 points (range 0-15); fourteen (60%) improved to 15. Sixty three (97%) with traumatic brain injury showed improvement, median change 14 (range 0-14). Forty (63%) improved to 15. CONCLUSION: Improvement in motor skills can be expected in children receiving neuro-rehabilitation for acute neurological impairments in the context of brain tumour treatment. The positive change in the SMFI score of their motor skills was similar to that seen in acquired brain injury of other aetiologies although a higher proportion of the latter group achieved a score at ceiling level.