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伴有下肢功能障碍的软组织肉瘤:基于破坏性和重建性手术类型制定特定康复方案

Soft Tissue Sarcoma with Lower Limb Impairment: Development of a Specific Rehabilitation Protocol Based on Demolitive and Reconstructive Surgery Types.

作者信息

Galluccio Caterina, Germanotta Marco, Valeri Sergio, Brunetti Beniamino, Vincenzi Bruno, Tenna Stefania, Pagnoni Chiara, Alloni Rossana, Angelucci Michela, Salzillo Rosa, Morelli Coppola Marco, Valeri Alice, Passa Roberto, Falchini Francesca, Pavan Arianna, Cortellini Laura, Lattanzi Stefania, Aprile Irene Giovanna

机构信息

IRCCS Fondazione Don Carlo Gnocchi Onlus, 50143 Florence, Italy.

Operative Research Unit of Soft-Tissue Sarcomas Surgery Department, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.

出版信息

J Clin Med. 2024 Nov 21;13(23):7023. doi: 10.3390/jcm13237023.

DOI:10.3390/jcm13237023
PMID:39685483
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11642672/
Abstract

Soft tissue sarcomas (STSs) are extremely uncommon tumors with a high rate of local recurrence that often require very demolitive surgery. The aim of our study is to propose a specific rehabilitation protocol for patients with STSs, based on the kind of demolition and reconstructive surgery performed, and evaluate its effects. : The protocol was developed on the basis of the clinical experiences of physiatrists and surgeons, as well as data from the literature, recommending timelines for postural steps, verticalization, walking, and therapeutic exercises, in accordance with wound healing times and in order to prevent complications from disuse and immobility. The modified Barthel Index Scale (mBI), the Numeric Rating Scale (NRS), the Adapted Patient Evaluation Conference System (APECS), and the 10 Meter Walk Test (10 MWT) were used to clinically evaluate patients before and after the rehabilitation treatment. : Thirty-one patients with primary STSs were enrolled. Following the rehabilitation program, we found a statistically significant improvement in mBI ( < 0.001), APECS ( ≤ 0.001), and NRS ( = 0.001). In a subgroup of patients ( = 18) assessed with the 10 MWT, a statistically significant increase in walking speed was observed ( = 0.012). : Patients who completed rehabilitation following the proposed protocol, customized according to the surgical intervention type, demonstrated marked improvements in motor performance, ability in daily activities, walking, and pain. The proposed protocol can assist the multidisciplinary team of surgeons, oncologists, and rehabilitators in maintaining alignment on patient management, thereby ensuring clear indications regarding the activities that patients can and cannot undertake during the recovery period.

摘要

软组织肉瘤(STSs)是极为罕见的肿瘤,局部复发率高,通常需要进行非常彻底的手术。我们研究的目的是根据所进行的根治性和重建性手术的类型,为STSs患者提出一种特定的康复方案,并评估其效果。:该方案是在物理治疗师和外科医生的临床经验以及文献数据的基础上制定的,根据伤口愈合时间推荐姿势调整、直立、行走和治疗性锻炼的时间安排,以防止因废用和不动导致的并发症。使用改良巴氏指数量表(mBI)、数字评定量表(NRS)、适应性患者评估会议系统(APECS)和10米步行测试(10 MWT)对康复治疗前后的患者进行临床评估。:纳入了31例原发性STSs患者。经过康复计划后,我们发现mBI(<0.001)、APECS(≤0.001)和NRS(=0.001)有统计学显著改善。在使用10 MWT评估的患者亚组(=18)中,观察到步行速度有统计学显著提高(=0.012)。:按照根据手术干预类型定制的拟议方案完成康复的患者,在运动表现、日常活动能力、行走和疼痛方面有明显改善。拟议的方案可以帮助外科医生、肿瘤学家和康复治疗师组成的多学科团队在患者管理上保持一致,从而确保明确指示患者在恢复期可以和不可以进行的活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4d9/11642672/dabf2c3d30a5/jcm-13-07023-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4d9/11642672/cfd7cc36def9/jcm-13-07023-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4d9/11642672/8ba8014e6fdb/jcm-13-07023-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4d9/11642672/b232092f4429/jcm-13-07023-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4d9/11642672/dabf2c3d30a5/jcm-13-07023-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4d9/11642672/cfd7cc36def9/jcm-13-07023-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4d9/11642672/8ba8014e6fdb/jcm-13-07023-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4d9/11642672/b232092f4429/jcm-13-07023-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4d9/11642672/dabf2c3d30a5/jcm-13-07023-g004.jpg

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