CORRECTION OF STRUCTURAL AND FUNCTIONAL MANIFESTATIONS OF SARCOPENIA USING PHYSICAL THERAPY IN ELDERLY PEOPLE AFTER LIVER RESECTION DUE TO COLORECTAL METASTASES

Abstract

Purpose – to assess the effectiveness of the developed physical therapy program for elderly people after liver resection for colorectal metastases according to the dynamics of functional and structural indicators of sarcopenia. Material. The control group consisted of 33 elderly people who were not diagnosed with oncological processes and sarcopenia. The group of elderly people after liver resection for colorectal metastases consisted of 33 people who underwent surgical and conservative treatment according to the unified clinical protocols of primary and specialized medical care “Colon cancer”, “Rectal cancer”. They were divided into two subgroups. The comparison group consisted of 31 people who recovered in the postoperative period according to the recommendations of the specified clinical protocols – modification of nutrition (Pevzner table No. 5), postoperative motor restrictions due to the presence of an abdominal scar, information on the features of further observation and treatment. The main group consisted of 32 people who underwent a developed comprehensive physical therapy program lasting six months in the postoperative period with the use of therapeutic exercises of various directions (aerobic, strength, to improve balance), differentiated according to the early and late postoperative periods, the chemotherapy period and the remote postoperative period, the educational component (in particular, regarding dietary modification, prevention of the risk of falls) taking into account individual rehabilitation goals. The effectiveness was assessed by the results of the Skeletal Muscle Index, handgrip dynamometry, Short Physical Performance Battery, Quality of Life Questionnaire Cancer Related Fatigue-12. Results. In elderly people after liver resection for colorectal metastases, the presence of sarcopenia was determined by low muscle tissue content (according to the Skeletal Muscle Index), functional manifestations – low hand strength in men and women, impairment in performing the Short Physical Performance Battery, physical weakness according to the results of the 6-minute test, the negative impact of specific fatigue caused by cancer on various activities (according to the Quality Of Life Questionnaire Cancer Related Fatigue-12). The approved comprehensive physical therapy program revealed an improvement in the condition of patients due to the impact on the studied structural and functional manifestations of sarcopenia due to an increase in muscle mass, expansion of motor functional capabilities when performing various activities compared to baseline indicators for all studied parameters (p<0,05). Conclusions. Physical therapy is appropriate for the comprehensive correction of structural and functional signs of sarcopenia at different stages of postoperative recovery in elderly people after liver resection for colorectal metastases.