EVALUATION OF THE EFFECTIVENESS OF A PHYSICAL THERAPY PROGRAM ACCORDING TO THE PARAMETERS OF MULTIFACTORIAL ASSESSMENT OF QUALITY OF LIFE IN ELDERLY PATIENTS AFTER LIVER RESECTION FOR COLORECTAL METASTASES

Abstract

Topicality. Colorectal cancer is one of the leading causes of cancer morbidity and mortality in the world. A significantproportion of patients are diagnosed with liver metastases, the treatment of which involves resection of the organ, which isa highly invasive intervention and significantly reduces the functional reserves of the body. Traditional recovery protocols (diet modification, movement restrictions, observation) do not provide sufficient restoration of quality of life, which justifies the need to implement structured physical therapy programs. The goal of the work is to evaluate the effectivenessof a comprehensive physical therapy program in elderly patients after liver resection for colorectal metastases according to the parameters of multifactorial quality of life. Materials and methods. 96 people aged 60–75 years (69.2 ± 0.8) were examined. The control group consisted of 33 individuals without oncological pathology. The comparison group (31 patients) consisted of patients after liver resection who recovered according to standard protocols. The main group (32 patients) consisted of individuals who underwent a comprehensive physical therapy program for 6 months, which included strength, aerobic and breathing exercises, gait and balance training, telerehabilitation and an educationalcomponent. Quality of life was assessed using the SarQoL, EORTC QLQ-C30 and SF-36 questionnaires at the stagesbefore the intervention and after 6 months. Research results. In the comparison group, moderate improvements werenoted after 6 months: general health according to QLQ-C30 increased by 13.3%, physical functioning – by 10.3%, role – by 11.1%, emotional – by 16.4%, social – by 11.8%. At the same time, cognitive functioning decreased by 3.6%, andpain and nausea remained without significant changes. In the main group, the comprehensive physical therapy programprovided a more pronounced increase: physical functioning – by 27.3%, role – by 30.5%, emotional – by 18.6%, social – by 16.7%. The greatest decrease in symptoms was recorded for fatigue (34.0%) and diarrhea (13.8%). According to the SF-36, in the comparison group, the increase was 18.8% in physical functioning and 21.8% in pain intensity, while in the main group the increase in these indicators was 31.4% and 28.8%, respectively, and mental health improved by 35.3%.According to SarQoL, the greatest positive changes were observed in the areas of activities of daily living (33.9%),mobility (32.2%), and reduction of fears (35.2%). Conclusions. A comprehensive physical therapy program in elderly patients after liver resection for colorectal metastases provides a systemic improvement in multifactorial quality of life,stabilizes psychoemotional state, and increases social activity. The results obtained confirm the feasibility of integratingphysical therapy programs into standard clinical routes for managing patients with colorectal cancer in the long-term postoperative period.