ORIGINAL ARTICLE Functional status of patients with metastatic spinal cord compression Danielle Zacaron Santos 1 & Isabel Cristina Gonçalves Leite 2 & Maximiliano Ribeiro Guerra 2,3 Received: 25 October 2017 / Accepted: 26 March 2018 # Springer-Verlag GmbH Germany, part of Springer Nature 2018 Abstract Purpose This prospective study was conducted to evaluate the functional status and clinical features of inpatients with metastatic spinal cord compression and to explore possible associated factors and the correlation with neurological deficits. Methods Cases were identified through an active search in the hospital units of the National Cancer Institute. For 47 patients, clinical and demographic characteristics were collected; functional status was measured by the Functional Independence Measure; modified Tokuhashi score was used to predict survival time; neurological deficits were measured using the American Spinal Injury Association Impairment Scale; and general condition was evaluated using the Karnofsky Performance Status Scale. The correlation between the level of neurological deficits and functional status was calculated using the Spearman correlation test. The difference in the functional independence score according to neurological status was assessed with the Kruskall-Wallis test. Results The degree of functional status was associated with Karnofsky Performance Status, level of neurological deficits, ability to walk, survival time, and skin color (p < 0.05). There was difference in the functional status (p = 0.004) and in the motor domain (p = 0.001) according to the level of neurological deficits. The correlation of the Functional Independence Measure with level of neurological deficits and with Karnofsky Performance Status was moderate (r = 0.46, p < 0.02). Conclusion The Functional Independence Measure was adequate for evaluating the functional status of patients with metastatic spinal cord compression. Palliative rehabilitation should be integrated early and strategies should be linked to the prognosis of survival. Keywords Rehabilitation . Functionality . Metastatic spinal cord compression . Palliative care . Prognosis Introduction Metastatic spinal cord compression (MSCC) occurs in ap- proximately 10% of oncology patients [1]. The main symp- toms are pain, muscle weakness, sensory loss, sphincter dysfunctions, and can progress to paraplegia/tetraplegia [2]. Survival time after MSCC diagnosis is poor [3] and is a de- terminant factor in therapeutic choices [4]. MSCC treatment aims to improve the quality of survival through pain relief, reduction of the risk of developing neuro- logical deficit, and improvement in carrying out the activities of daily living [5]. Changes in the independent capacity to perform activities such as toileting, dressing, bathing, combing hair, ambulation, stair climbing, and transfers are common in patients with MSCC, and impact their quality of life [6, 7]. Thus, the diag- nosis of cancer associated with MSCC can be a burden for patients and their relatives [8]. Rehabilitation, even in the more advanced stages of onco- logical disease, may help restore functional capacity or delay its decline [9]. Through the maintenance and improvement of functional capacity, total pain relief is also promoted, in which suffering encompasses physical, psychological, social, spiri- tual, and daily efforts [10]. Currently, there is a gap in the discussion on rehabilitation for patients with MSCC, due to the difficulty of therapeutic * Danielle Zacaron Santos daniellezacaron@gmail.com Isabel Cristina Gonçalves Leite isabel.leite@ufjf.edu.br Maximiliano Ribeiro Guerra guerramr@hotmail.com 1 Physical Therapy Department, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Boulevard 28 de Setembro, no. 77, Vila Isabel, Rio de Janeiro 20551-030, Brazil 2 Master’ s Program in Public Health, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil 3 Inserm U900, Paris Institut Curie, Paris Mines ParisTech, Fontainebleau, PSL Research University, Paris, France Supportive Care in Cancer https://doi.org/10.1007/s00520-018-4182-5