Glioblastoma is the most common primary malignant brain tumor. While preliminary data point to the positive effects of rehabilitation for patients with glioblastoma, there are unique challenges for clinicians working with this population, including limited life expectancy and/or rapid neurological deterioration. The aim of this article is to review the literature on rehabilitation of adults with glioblastoma, including the feasibility of interventions, their effectiveness, as well as the current clinical practice. The reviewed literature suggests that rehabilitation has been found beneficial for improving the functional prognosis and quality of life of adults with glioblastoma and is desired by patients. We summarize the qualitative evidence regarding healthcare professionals’ and patients’ perspectives on the use of supportive care services. We conclude there is a need for the design of effective rehabilitation programs for patients with glioblastoma, as well as for the development of glioblastoma-specific clinical guidelines for rehabilitation practitioners.

A brain tumour can be a life-threatening illness and cause unique symptoms compared to other types of cancer, such as cognitive or language deficits, or changes in personality. It is an exceptionally distressing diagnosis which can affect quality of life, even for those with a low-grade tumour or many years after the diagnosis. This study sought to gain an in-depth understanding of the lived experience of adjustment to living with a brain tumour. Twelve individuals (83% female) with a primary brain tumour (83% low-grade) took part in the study. Participants were aged 29–54 years, on average 43 months following the diagnosis, and were recruited through the charitable support organisations in the United Kingdom. In-depth semi-structured interviews were conducted, transcribed verbatim, and analysed using interpretative phenomenological analysis (IPA). Six inter-related themes were identified: making sense of the diagnosis, seeking empowerment, feeling appreciative, taking charge of coping, learning to accept, and negotiating a new normality. Notions of empowerment, gratitude, and acceptance throughout the illness journey were prominent in the participants’ narratives. Receiving sufficient information and initiating treatment were important in negotiation of control. The results highlighted what facilitates and hinders adaptive coping. Aspects which facilitated positive coping were as follows: trust in clinician, feeling in control, feeling grateful, or accepting. Participants on a ‘watch and wait’ approach, while feeling appreciative, perceived the lack of treatment as difficult and frustrating. Implications for patient–clinician communication are discussed, particularly for patients on a ‘watch and wait’ who might need additional support in adjusting.

Primary brain tumor presents symptoms related to both cancer and neurological condition. Due to unique characteristics and related care demands, neuro-oncology family caregivers experience different challenges compared to family members of other cancer survivors. The purpose of this study was to understand the informal caregivers' lived experiences of coping, support needs, and changes in relationships while caring for family member or friend with a brain tumor. In-depth interviews were conducted with 10 informal caregivers of people diagnosed with a primary brain tumor. The mean age of participants was 45 years (range 19-68 years), and 90% of participants were female (n = 9). Time since diagnosis of the family member ranged from 1 month to 13 years (mean = 4 years). Interviews were transcribed verbatim and analyzed using Interpretative Phenomenological Analysis. Five interrelated themes were identified following the analysis: (1) Exhaustion and all-consuming role, (2) experiencing rupture and loss, (3) togetherness and isolation, (4) navigating healthcare and lack of support, and (5) anticipating grief. There was an overarching sense of loneliness, loss on multiple levels, and feeling invisible in their caregiving role. Neuro-oncology caregiving was described as an extremely challenging and lonely experience. The current findings support calls for healthcare services redesign which would provide family-based cancer care. Findings highlight the importance of involving informal caregivers of persons with a brain tumor in the treatment process and their important role be acknowledged.

Owing to the global aging of people with multiple sclerosis (pwMS), there is an emerging need to distinguish neurological disability from age-related conditions in this population. To examine the overlap between frailty, disability, and comorbidity in pwMS, and their associations with quality of life (QoL) and falls. Two hundred and three pwMS (mean age=51.8 ± 12.6 years; median Patient Determined Disease Steps (PDDS) score=1.0 [IQR=2.0]; 73.9% women) underwent established assessments of frailty (FRAIL scale, Tilburg frailty indicator, and frailty index), disability (PDDS), comorbidity (Charlson comorbidity index), QoL (MSQoL-54), and falls (12-month fall-history survey). Frailty, disability, and comorbidity were distinct but overlapping: 1.5-10.3% of participants had frailty alone, 4.4-14.3% had disability alone, and 11.8-14.3% had comorbidity alone; between 9.4% and 19.7% had all three. Multivariable quantile and logistic regression analyses revealed that all frailty measures were more strongly associated with lower QoL (median regression coefficients ≤-4.76, p-values˂0.001) and greater odds of falling (OR_s ≥1.47, p-values≤0.001) than disability or comorbidity. Participants with all three conditions had significantly worse physical QoL and a higher median number of falls than those with any one condition alone. Frailty, disability, and comorbidity represent separate conditions in pwMS, as they can present in isolation, and each has distinct associations with QoL and falls. Comprehensive assessment of all three conditions may enhance risk stratification and inform individualized rehabilitation and aging support strategies.

While falls are the leading cause of accidental injury among older people, the current fall prevention strategies have not resulted in a remarkable reduction in fall rates. An alternative novel approach, teaching older adults how to fall safely to prevent injury, has been recently implemented in the FAlling Safely Training (FAST) trial. The current study aimed to explore the views and perceptions of older people about their participation in the safe-falling training program. Focus groups were conducted with eight community-dwelling older adults (age range: 66 to 76 years, five females) at risk of falling who completed the FAST program. Two focus groups involving four participants each were conducted. Recordings were transcribed verbatim and analyzed using thematic analysis. Three themes were identified following the analysis: (1) Before the training; with subthemes: Previous fall prevention strategies and Motivation to participate. Motivations to take part in the training included worries about falling, an awareness of an increased risk of falling, and a desire to decrease the chances of sustaining an injury. (2) Training itself; with subthemes: General impressions of the training and Learning the techniques. Older people highlighted that the training was well-designed and executed. (3) Going forward; with subthemes: Training increased confidence, Incorporating in a community setting, and Proposing improvements to the study. It was reported that the training enhanced participants’ confidence about falling without injury. Incorporating the training into a community context was discussed, and suggestions for program enhancements were made. The individual nature of the training was valued, but participants also provided suggestions for how they would see the program taking place successfully in small groups. The results indicated that the safe-falling training was acceptable to older adults. The perceived ability to fall without injury was reported to have increased. Individuals who experienced a fall after the training ended reported being able to use the techniques learned in their daily life. The findings have implications for the training to be refined and implemented in the community. The article is linked to a randomized controlled trial registered at http://ClinicalTrials.gov (NCT05260034).