S98

post operatory and directed to our clinic. Here the patient underwent
medical gymnastic exercises up to 60 degrees abduction in shoulder joint
for a 6-week period. Afterwards the exercises focused on improving
mobility in the upper limb keeping a 60 degree range of motion (ROM) in
the shoulder joint and performing the rest of the movements from the
elbow and st joints. Assessment/Results: The 6-week evaluation
showed 60 degrees of abduction in the shoulder joint without external
rotation; at 3 months follow-up the patient showed perfect ability in
coordinating mobility keeping the 60 degree ROM allowed by the prosthesis. At the 1-year follow-up the patient presented a complete recovery of
daily living activities without the need of retiring. Discussions: The
particularities of this case consist in the large piece of humeral bone and
shoulder joint resected that requested a bio-membrane coating surounding
the metal prosthetics that allowed the functionality of the tendons and
nerves. Conclusions: The complex orthopedic rehabilitation treatment
in metastatic bone fractures is still a challenge for the twenty-rst century
medicine that benets from research in bio-nano-technologies and imagistics providing the patient a high satisfaction index.

No. 4 Multidisciplinary Rehabilitation in Persons With

Primary Brain Tumour: A Controlled Clinical Trial.
Fary Khan, MBBS; Bhasker Amatya, MD MPH;
Mary Galea, Phd Bappsci (Physio) BA Grad Dip Physio Grad
Dip Neurosci; Kate Drummond.
Disclosure: None. Objective: To evaluate the effectiveness of multidisciplinary (MD) rehabilitation program for persons with brain tumour
(BT) (gliomas) in an Australian community cohort. Design: Controlled
clinical trial. Settings: Ambulatory rehabilitation settings. Participants: The BT survivors (n 106) in the community were allocated
either to the treatment group (n53) or waitlist control group (n53)
irrespective of their tumour grade severity and duration by treating team
based on their requirement. Interventions: The treatment group received
individualized intensive ambulatory (centre-based) MD rehabilitation while
the waitlist patients were the control group who continued with their usual
activity in the community. Main Outcome Measures: The primary
outcome functional independence measure (FIM) measured activity limitation. Secondary measures included depression anxiety stress scale (DASS),
perceived impact problem prole (PIPP), and cancer rehabilitation evaluation system short-form (CARES-SF). Assessments were at baseline 3 and 6
months. Results: Participants were predominantly female (56%), with
mean age 5113.6 years (range from 21 to 77 years) and median time since
diagnosis of 2.1 years (inter quartile range 0.9 to 4.0). Intention-to-treat
analysis showed a signicant difference between groups at 3-month in
favour of MD program in FIM motor subscales: self-care, sphincter,
locomotion, mobility (p<0.01 for all); and FIM communication (p<0.01)
and psychosocial subscales (p<0.05) with small to moderate effect size
(r0.2-0.4). At 6-month follow-up signicant improvement in the treatment group was maintained only for FIM sphincter communication and
cognition subscales (p<0.01 for all). No difference between groups was
noted in other subscales. Conclusions: BT rehabilitation is challenging
due to high mortality rates, often progressive in nature, uncertain prognosis
with multifaceted physical and cognitive disabilities and participatory
limitations. BT survivors can improve function with MD rehabilitation with
some gains maintained up to 6 months. Evidence for specic interventions
in the blackbox of rehabilitation is needed.
No. 5 Effects of Exercise Interventions on Pro-Inammatory
Biomarkers in Breast Cancer Survivors.
Jos Francisco Meneses-Echvez; Robinson Ramrez-Vlez.
Disclosure: None. Objective: To determine the effects of exercise
interventions on pro-inammatory biomarkers in breast cancer survivors.
Design: Systematic review and metaanalysis using a random-effects
model. Setting: University campus e databases. Participants: Breast

PRESENTATIONS

cancer survivors (>20 years old) without restrictions to a particular stage of

treatment or therapeutic regimen (chemotherapy, radiotherapy or combination). Interventions: Exercise interventions including aerobic resistance and stretching training programs. Comparator: Conventional care or
no-intervention. Search strategy: PRISMA statement was followed. Databases of Medline, Embase Scopus and Central were search until February
2014 by two blinded authors (J.F.M.E., R.R.V.) to identify randomized
controlled trials. There were not language restrictions. Risk of bias was
evaluated with the Pedro scale. Main Outcome Measures: Primary
outcome measures were inammatory biomarkers (interleukin-2 IL-6 IL-8
TNF and C-reactive protein (CRP)). Secondary outcome were: insulin
glucose, insulin resistance and insulin-like growth factor binding proteins
and body mass index (BMI). Data Analysis: Random effects model
estimating standardized mean difference for differences between groups
(p<0.05 with 95% CI). Heterogeneity was evaluated with chi2 and i2
statistics. Results: seven studies were included (n929; age51.83.1
years old) with a low risk of bias (Pedro6.21.3). Exercise improved IL-2
(SMD -6.04; 95%; IC -11.41 to -0.67; p0.03; I2 0%) whilst non
signicant differences were observed for IL-6, IL-8, TNF and CRP. Additional improvements were observed for secondary outcomes such as
glucose insulin, HOMA and BMI, although these differences were no
signicant. There were no evidence of publication bias and considerable
heterogeneity between studies. Conclusions: Exercise can improve some
pro-inammatory biomarkers related to immunological responses and
carcinogenic process although evidence based on clinical trials remains
unclear. Further research is encouraged.

No. 6 Effects of Supervised Exercise on Cancer-Related

Fatigue in Breast Cancer Survivors: A Systematic Review
and Metaanalysis.
Jos Francisco Meneses-Echvez; Robinson Ramrez-Vlez;
Emilio Gonzlez Jmenez.
Disclosure: None. Objective: To determine the pooled effects
of supervised exercise interventions on cancer-related fatigue (CRF) in breast
cancer survivors. Participants: Breast cancer survivors (>20 years old)
without restriction to treatment stage. Methods: PRISMA statement was
followed. Databases of Pubmed/Medline, Embase, Scopus Central and
CINAHL were searched until January 2014 without language restrictions.
Risk of bias and methodological quality were evaluated with the Pedro score.
Polled effects were calculated in stata version 11 through a random-effects
model. Heterogeneity was evaluated with the chi2 test (p<0.10) and i2
statistics (i2>50%). Results: Nine high quality studies (n1156) were
included. Supervised aerobic exercise was statistically more effective than
conventional care in improving CRF among breast cancer survivors (SMD
-0.37 95%CI [-0.70 -0.40]) p<0.00001; i2 80%. Resistance training
produced signicant improvements on CRF SMD-0.55 95%CI (-1.09 to
-0.01) p<0.00001; i2 84%. There was no evidence of publication bias.
Conclusion: Supervised exercise reduces CRF and must be implemented
in rehabilitation settings treating breast cancer survivors. Further research is
suggested.
No. 7 Survey of Oncologic Patients Who Followed Curative
Surgery and a Rehabilitation Program.
Dan Nemes; Elena Amaricai; Diana Andrei; Cristian Milicin.
Objectives: To assess the level of communication of oncologic patients
with their surgical oncologists and rehabilitation specialists. To evaluate the
main symptoms/disorders for oncologic patients who needed curative surgery
and were addressed to a rehabilitation program. Design: Cross-sectional
study. Setting: A surgical oncology unit and a rehabilitation department.
Participants: 60 patients diagnosed with breast, gynaecological, urological,
gastrointestinal or pancreas cancer interventions. The oncologic patients
followed curative surgery. Following recovery after the surgical procedure,
they were addressed to a rehabilitation specialist who performed progressive