The application of fluctuating currents in the early postoperative period in patients after operations on mammary gland

Russian Journal of Physiotherapy, Balneology and Rehabilitation

2022

BACKGROUND: every year in the world, up to 1.5 million primary cases of breast cancer are verified and more than 500 thousand women die. More than 60% of patients diagnosed with breast cancer report functional disorders both during treatment and after its completion. In recent years, the attention of scientists and doctors has been paid to the rehabilitation of cancer patients. But questions remain open concerning the awareness and qualifications of doctors working in the field of medical rehabilitation of the problem of malignant neoplasms of the breast and the organization of medical rehabilitation in medical organizations providing medical care to patients in the field of oncology. AIMS: to determine the level of knowledge among doctors of various specialties planning to work in the field of physical and rehabilitation medicine on the problem of medical rehabilitation of patients with malignant neoplasms of the mammary gland. MATERIALS AND METHODS: а survey was conducted on a questionnaire developed at the Department of Physical Therapy, Sports Medicine and Medical Rehabilitation of the Russian Ministry of Health, which included 211 doctors working in 38 medical institutions in the profile medical rehabilitation, 6 clinical specialties. RESULTS: the questionnaire survey demonstrated the relevance of the problem for the clinical activities of specialists working in the field of physical and medical rehabilitation (89.5%), however, the lack of knowledge in 72.7% of respondents creates the need to increase the level of professional competencies of specialists, namely, conducting specialized and multidisciplinary seminars and conferences, the introduction of new training programs for advanced training. CONCLUSION: The questionnaire created by us is a reliable tool for assessing the level of knowledge of medical professionals. The conducted research allows us to conclude that doctors are not sufficiently knowledgeable in the field of medical rehabilitation of cancer patients. In this regard, it is undoubtedly important to inform all doctors planning further work in the field of physical and rehabilitation medicine about modern research, methods of treatment and rehabilitation of patients with malignant neoplasms of the breast.

unclassified

Assessment of the quality of knowledge about medical rehabilitation among doctors

Russian Journal of Physiotherapy, Balneology and Rehabilitation

2022

Influence of physiotherapy on the electrical excitability of the shoulder muscles in the early postoperative period after radical surgical treatment of breast cancer

Russian Journal of Physiotherapy, Balneology and Rehabilitation

Gerasimenko

Есимова

2022

BACKGROUND: Combined treatment of cancer patients includes a large number of aggressive therapies that lead to a complex of functional disorders. There are no publications on the influence of physical factors on the electrical excitability of the muscles of the shoulder girdle and upper limb from the side of surgery in the early period after surgical treatment of breast cancer. AIM: To determine the physical factor that will most significantly affect the electrical excitability of the muscles of the shoulder girdle and upper limb on the side of the operation after radical surgical treatment of breast cancer. MATERIAL AND METODS: A randomized, placebo-controlled study was conducted in 100 patients in the early postoperative period (24 days after surgery) for breast cancer. All patients underwent medical rehabilitation: individual physiotherapy exercises, balance therapy, sessions with a medical psychologist, physiotherapy treatment with a monofactor. The main group included 34 patients who included an extended method of fluctuorization in the course of medical rehabilitation and additionally underwent fluctuorization of the muscles of the forearm, group 2 (comparisons, n=33) the extended method of local magnetotherapy was included in the rehabilitation program and group 3 (comparisons, n=33) in addition to rehabilitation, general magnetic therapy procedures were performed. Patients underwent a study of the excitability of the neuromuscular system on the apparatus of stimulation and electrotherapy ASEtM-01/6 "Elesculap Med TeKo". RESULTS: It was found that fluctuating currents turned out to be more effective in the early stages, which pathogenetically contribute to the restoration of conduction along the peripheral nerves and the activation and contractility of the muscle fiber. A delayed effect of local and general magnetic therapy on improving the contractility of the muscles of the upper limb and the conductivity of the peripheral nerve fiber was noted. CONCLUSION: The inclusion of monophysical factors in the course of standard medical treatment, a course of physical therapy, exercises on a stabiloplatform and individual psychotherapy in the early stages (on days 24) after surgery contributed to the improvement in the functioning of the upper limb and the restoration of the electrical excitability of the muscles and nerves of the operated limb.

Application of Physical Factors at the First Stage of Medical Rehabilitation after Radical Surgical Treatment of Breast Cancer

Bulletin of Rehabilitation Medicine

Gerasimenko

Есимова

2022

There are a large number of publications confirming the clinical safety of the of physiotherapy application in patients with malignant neoplasms of the breast, but scientific studies on the physical factors complex use in medical rehabilitation of this group of patients in the early postoperative period have not been published yet. Aim. To determine the effectiveness of fluctuating currents in combination with pneumocompression, general magnetotherapy, local magnetotherapy, low-temperature argon plasma applied for patients after radical surgical treatment of breast cancer in the early postoperative period. Material and methods. A prospective, simple, randomized study involving 190 women diagnosed with breast cancer in the early postoperative period after radical Madden mastectomy or radical breast resection (2–4 days) was performed, the average age was 58±10.61 years. The control group consisted of patients included in the course of rehabilitation (exercise therapy, balance therapy and classes with a medical psychologist) fluctuating currents. Low-temperature argon plasma, intermittent pneumocompression, general and local magnetotherapy were added to fluctuations for patients in the main groups. Results and discussion. The analysis of the clinical and functional data showed that in the early postoperative period for breast cancer against the background of the standard drug therapy and the course of medical rehabilitation, the combination of fluctuating currents with intermittent pneumocompression, general and local magnetotherapy significantly reduced the degree of the upper limb edema and the volume of lymphorrhea. The addition of general and local magnetotherapy affects the decrease in the indicators of the shoulder girdle and forearm muscles electrical excitability. Low temperature argon plasma improves the regeneration of the postoperative suture and reduces swelling and inflammation in this area. The dynamics of the decrease in the level of anxiety and depression, pain syndrome and the general condition of cancer patients are most pronounced in the groups that additionally received magnetotherapy. The volume and quality of movements, muscle strength significantly increased in all groups without differences in results. The action of magnetic fields contributes to the increase of tissue oxygenation, due to which an anti-inflammatory and decongestant effect is realized. Fluctuation of the shoulder girdle and forearm muscles leads to normalization of the functional electrical excitability of the muscles by surgical treatment, which allows to restore the motor stereotype of the limb in a short time, and intermittent pneumocompression affecting the skin and tissue structures of the lower extremities and trunk improves the overall lymph flow, which does not lead to stagnation of lymph in the operated area. Conclusion. Thus, the combined application of physical factors against the background of the standard drug therapy and the course of medical rehabilitation significantly improves the result and recovery time after surgical treatment of the breast cancer in the early postoperative period. A comprehensive approach to medical rehabilitation at the I stage led to the preservation of results in the long-term period 1.5 and 6 months after the operation without adverse events.