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术前身体康复能否改善接受胃肠道癌手术患者的功能结局?

Does pre-operative physical rehabilitation improve the functional outcomes of patients undergoing gastrointestinal cancer surgery?

作者信息

Hara Tsuyoshi, Kogure Eisuke, Kubo Akira, Kakuda Wataru

机构信息

Department of Physical Therapy, School of Health Science, International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi 324-8501, Japan.

Rehabilitation Progress Center Inc, Tokyo, Japan.

出版信息

J Phys Ther Sci. 2021 Mar;33(3):299-306. doi: 10.1589/jpts.33.299. Epub 2021 Mar 17.

Abstract

[Purpose] This study aimed to evaluate the effectiveness of pre-operative physical rehabilitation on the postoperative course of the patients with gastrointestinal cancer undergoing surgery. [Participants and Methods] A rehabilitation physician examined and educated 33 patients (42% of whom were male with a mean age of 65.2 ± 10.9 years) who were scheduled to undergo elective surgery for gastrointestinal cancer. They received instructions for performing exercise from a physical therapist 17.0 ± 7.3 days prior to surgery. We divided the participants into three groups (improvement, maintenance, and deterioration) based on the changes in their ability to walk prior to surgery. This study compared the results of the 6-min walk test, hospital anxiety and depression scale, and 36-Item Short-Form Health Survey version 2 for the three groups at baseline, following rehabilitation prior to surgery, and 4 weeks following surgery. [Results] In the improvement group, the decrease in the ability to walk between the baseline and 4 weeks after surgery was not significant. Conversely, the deterioration group exhibited a significant decrease in the ability to walk 4 weeks after surgery. [Conclusion] Improvement in walking ability by rehabilitation training prior to surgery leads to the preservation of physical function in the patients with gastrointestinal cancer undergoing surgery.

摘要

[目的] 本研究旨在评估术前身体康复对接受手术的胃肠道癌患者术后病程的有效性。[参与者与方法] 一名康复医师对33例计划接受胃肠道癌择期手术的患者进行了检查和指导(其中42%为男性,平均年龄65.2±10.9岁)。他们在手术前17.0±7.3天从物理治疗师那里接受了运动指导。我们根据患者术前行走能力的变化将参与者分为三组(改善组、维持组和恶化组)。本研究比较了三组患者在基线、术前康复后以及术后4周时的6分钟步行试验结果、医院焦虑抑郁量表和简明健康状况调查简表第2版结果。[结果] 在改善组中,基线至术后4周的行走能力下降不显著。相反,恶化组在术后4周时行走能力显著下降。[结论] 术前康复训练改善行走能力可使接受手术的胃肠道癌患者保持身体功能。

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