ASSESSMENT OF MULTIDOMAIN QUALITY OF LIFE IN PATIENTS FOLLOWING SURGICAL TREATMENT OF MALIGNANT TUMORS OF THE MAXILLOFACIAL REGION UNDER THE INFLUENCE OF PHYSICAL THERAPY

Abstract

Objective – to assess the effectiveness of physical therapy in restoring multidomain quality of life in patients with the consequences of surgical treatment of malignant neoplasms of the maxillofacial region, taking into account functional, psychological and social indicators.Material. The study included 12 patients (men and women aged 40–69 years) who underwent surgery for malignant tumors of the maxillofacial region. All patients had individually made prostheses to close the defects and provide functional compensation. The rehabilitation program included 21 physical therapy sessions, each lasting up to 60 minutes. During the normative part, therapeutic exercises for masticatory and facial muscles, neck muscles, shoulder girdle, manual mobilization of soft tissue scars, breathing exercises (nose and mouth breathing), relaxation exercises were performed. The variable part included measures selected according to individual indications – manual correction of lymphostasis, kinesiological taping of the face and neck area to reduce edema and facilitate exercise performance, swallowing training, exercises to improve voice function, individual functional training to correct dysfunctions associated with the maxillofacial area and neck. Quality of life was assessed using the OHIP-14, EORTC QLQ-C30, SF-36 questionnaires.Results. Before therapy, participants demonstrated a pronounced decrease in quality of life on all scales. According to OHIP-14, most domains had the maximum possible median of 8 points, the total score was 52 [51; 54], which indicates severe somatic and socio-psychological maladjustment. According to EORTC QLQ-C30 Global health status – 25 [9; 41], physical functioning – 23 [11; 31], emotional – 15 [6; 24]. SF-36 indicated reduced energy, pain, poor psycho-emotional state and limited social activity. After physical therapy, a statistically significant improvement was observed in most domains: in OHIP-14 the total score decreased to 37 [34; 42]; in QLQ-C30 the indicators of physical, emotional, social functioning increased; in SF-36 the indicators of Vitality, Role physical, Bodily pain, Mental health improved.Conclusions. The introduction of physical therapy into the rehabilitation program of patients with the consequences of surgical treatment of maxillofacial tumors contributes to a significant improvement in physical, emotional and social functioning, a decrease in symptoms and an increase in the quality of life.