S98 PRESENTATIONS

post operatory and directed to our clinic. Here the patient underwentmedical gymnastic exercises up to 60 degrees abduction in shoulder jointfor a 6-week period. Afterwards the exercises focused on improvingmobility in the upper limb keeping a 60 degree range of motion (ROM) inthe shoulder joint and performing the rest of the movements from theelbow and fist joints. Assessment/Results: The 6-week evaluationshowed 60 degrees of abduction in the shoulder joint without externalrotation; at 3 months follow-up the patient showed perfect ability incoordinating mobility keeping the 60 degree ROM allowed by the pros-thesis. At the 1-year follow-up the patient presented a complete recovery ofdaily living activities without the need of retiring. Discussions: Theparticularities of this case consist in the large piece of humeral bone andshoulder joint resected that requested a bio-membrane coating suroundingthe metal prosthetics that allowed the functionality of the tendons andnerves. Conclusions: The complex orthopedic rehabilitation treatmentin metastatic bone fractures is still a challenge for the twenty-first centurymedicine that benefits from research in bio-nano-technologies and imag-istics providing the patient a high satisfaction index.

No. 4 Multidisciplinary Rehabilitation in Persons WithPrimary Brain Tumour: A Controlled Clinical Trial.Fary Khan, MBBS; Bhasker Amatya, MD MPH;Mary Galea, Phd Bappsci (Physio) BA Grad Dip Physio GradDip Neurosci; Kate Drummond.

Disclosure: None. Objective: To evaluate the effectiveness of multi-disciplinary (MD) rehabilitation program for persons with brain tumour(BT) (gliomas) in an Australian community cohort. Design: Controlledclinical trial. Settings: Ambulatory rehabilitation settings. Partic-ipants: The BT survivors (n ¼ 106) in the community were allocatedeither to the treatment group (n¼53) or waitlist control group (n¼53)irrespective of their tumour grade severity and duration by treating teambased on their requirement. Interventions: The treatment group receivedindividualized intensive ambulatory (centre-based) MD rehabilitation whilethe waitlist patients were the control group who continued with their usualactivity in the community. Main Outcome Measures: The primaryoutcome functional independence measure (FIM) measured ‘activity’ limi-tation. Secondary measures included depression anxiety stress scale (DASS),perceived impact problem profile (PIPP), and cancer rehabilitation evalua-tion system short-form (CARES-SF). Assessments were at baseline 3 and 6months. Results: Participants were predominantly female (56%), withmean age 51�13.6 years (range from 21 to 77 years) and median time sincediagnosis of 2.1 years (inter quartile range ¼ 0.9 to 4.0). Intention-to-treatanalysis showed a significant difference between groups at 3-month infavour 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(r¼0.2-0.4). At 6-month follow-up significant improvement in the treat-ment group was maintained only for FIM ‘sphincter’ ‘communication’ and‘cognition’ subscales (p<0.01 for all). No difference between groups wasnoted in other subscales. Conclusions: BT rehabilitation is challengingdue to high mortality rates, often progressive in nature, uncertain prognosiswith multifaceted physical and cognitive disabilities and participatorylimitations. BT survivors can improve function with MD rehabilitation withsome gains maintained up to 6 months. Evidence for specific interventionsin the ‘blackbox’ of rehabilitation is needed.

No. 5 Effects of Exercise Interventions on Pro-InflammatoryBiomarkers in Breast Cancer Survivors.José Francisco Meneses-Echávez; Robinson Ramírez-Vélez.

Disclosure: None. Objective: To determine the effects of exerciseinterventions on pro-inflammatory biomarkers in breast cancer survivors.Design: Systematic review and metaanalysis using a random-effectsmodel. Setting: University campus e databases. Participants: Breast

cancer survivors (>20 years old) without restrictions to a particular stage oftreatment or therapeutic regimen (chemotherapy, radiotherapy or combi-nation). Interventions: Exercise interventions including aerobic resis-tance and stretching training programs. Comparator: Conventional care orno-intervention. Search strategy: PRISMA statement was followed. Data-bases of Medline, Embase Scopus and Central were search until February2014 by two blinded authors (J.F.M.E., R.R.V.) to identify randomizedcontrolled trials. There were not language restrictions. Risk of bias wasevaluated with the Pedro scale. Main Outcome Measures: Primaryoutcome measures were inflammatory biomarkers (interleukin-2 IL-6 IL-8TNF and C-reactive protein (CRP)). Secondary outcome were: insulinglucose, insulin resistance and insulin-like growth factor binding proteinsand body mass index (BMI). Data Analysis: Random effects modelestimating 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 (n¼929; age¼51.8�3.1years old) with a low risk of bias (Pedro¼6.2�1.3). Exercise improved IL-2(SMD¼ -6.04; 95%; IC -11.41 to -0.67; p¼0.03; I2¼ 0%) whilst nonsignificant differences were observed for IL-6, IL-8, TNF and CRP. Addi-tional improvements were observed for secondary outcomes such asglucose insulin, HOMA and BMI, although these differences were nosignificant. There were no evidence of publication bias and considerableheterogeneity between studies. Conclusions: Exercise can improve somepro-inflammatory biomarkers related to immunological responses andcarcinogenic process although evidence based on clinical trials remainsunclear. Further research is encouraged.

No. 6 Effects of Supervised Exercise on Cancer-RelatedFatigue in Breast Cancer Survivors: A Systematic Reviewand Metaanalysis.José Francisco Meneses-Echávez; Robinson Ramírez-Vélez;Emilio González Jímenez.

Disclosure: None. Objective: To determine the pooled effectsof supervised exercise interventions on cancer-related fatigue (CRF) in breastcancer survivors. Participants: Breast cancer survivors (>20 years old)without restriction to treatment stage. Methods: PRISMA statement wasfollowed. Databases of Pubmed/Medline, Embase, Scopus Central andCINAHL 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-effectsmodel. Heterogeneity was evaluated with the chi2 test (p<0.10) and i2

statistics (i2>50%). Results: Nine high quality studies (n¼1156) wereincluded. Supervised aerobic exercise was statistically more effective thanconventional care in improving CRF among breast cancer survivors (SMD¼-0.37 95%CI [-0.70 -0.40]) p<0.00001; i2¼ 80%. Resistance trainingproduced significant improvements on CRF SMD¼-0.55 95%CI (-1.09 to-0.01) p<0.00001; i2¼ 84%. There was no evidence of publication bias.Conclusion: Supervised exercise reduces CRF and must be implementedin rehabilitation settings treating breast cancer survivors. Further research issuggested.

No. 7 Survey of Oncologic Patients Who Followed CurativeSurgery and a Rehabilitation Program.Dan Nemes; Elena Amaricai; Diana Andrei; Cristian Milicin.

Objectives: To assess the level of communication of oncologic patientswith their surgical oncologists and rehabilitation specialists. To evaluate themain symptoms/disorders for oncologic patients who needed curative surgeryand were addressed to a rehabilitation program. Design: Cross-sectionalstudy. Setting: A surgical oncology unit and a rehabilitation department.Participants: 60 patients diagnosed with breast, gynaecological, urological,gastrointestinal or pancreas cancer interventions. The oncologic patientsfollowed curative surgery. Following recovery after the surgical procedure,they were addressed to a rehabilitation specialist who performed progressive