Effectiveness of rehabilitation of elderly people after cholecystectomy in outpatient settings

Nataliya Golod; Tetiana Buhaienko; Ljudmyla Rusyn; Ivan Salatenko

doi:10.15391/prrht.2024-9(6).05

Authors

Nataliya Golod Department of physical therapy and occupational therapy, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine https://orcid.org/0000-0003-0996-6920
Tetiana Buhaienko Department of the therapy and rehabilitation, Sumy State Pedagogical University named after A.S.Makarenko, Sumy, Ukraine https://orcid.org/0000-0003-3745-0593
Ljudmyla Rusyn Department of fundamentals of medicine, Uzhhorod National University, Uzhhorod, Ukraine https://orcid.org/0000-0002-0839-1072
Ivan Salatenko Department of physical education, Sumy National Agrarian University, Sumy, Ukraine https://orcid.org/0000-0002-4762-633X

DOI:

https://doi.org/10.15391/prrht.2024-9(6).05

Keywords:

physical rehabilitation, ICF, cholecystectomy, function, activity, participation, older age

Abstract

Purpose. To determine the dynamics of functioning, activity and participation using the International Classification of Functioning (ICF) as a criterion for the effectiveness of rehabilitation of elderly people after laparoscopic cholecystectomy (LCC). To conduct a comparative analysis of the levels of functioning, activity, and participation of elderly people according to the ICF in the post-acute and long-term phases of rehabilitation in outpatient settings.

Material & Methods. The study included elderly people aged 60 to 74 years after LCC (n=80), including men (n=18) and women (n=62). The study is a simple randomized trial using a simple random selection method with a draw. A control group (CG) and a main group (MG) were formed. Individuals in the MG received rehabilitation using a biopsychosocial approach in the subacute phase of rehabilitation. They were assessed for impairment in functioning, activity, and participation using the ICF, with results based on clinical instruments depending on the domain of the ICF. Statistical analysis. Calculations included the measurement of the median (Me) and the upper and lower quartiles (25%; 75%). The Mann-Whitney U-test was used to compare independent samples and the Wilcoxon T-test – to compare dependent samples; differences at p<0,05 were considered statistically significant.

Results. After discharge from the surgical unit, individuals after LCC had impaired emotional function, sleep, digestive system, decreased respiratory function, pain, impaired postural balance, movement function, decreased exercise tolerance, decreased muscle strength, and decreased muscle endurance.

Conclusions. In the CG, the use of diet and symptomatic medication support showed a positive effect on the gastrointestinal tract, but did not significantly affect the functions of physical activity tolerance, endurance, trunk muscle strength, vestibular and other significant functions, which usually negatively affects the further rehabilitation prognosis and quality of life. The dynamics of functioning, activity and participation in elderly people was statistically significant in the MG. During the first 3 months, under the influence of therapeutic exercises, functional training, cyclical aerobic exercises and fall management, statistically significant positive changes occurred in vestibular functions, exercise tolerance, respiratory function, activity and participation. It was found that the effective impact of a physical rehabilitation program designed to address short- and long-term goals on function, activity, and participation based on the use of ICF in combination with symptomatic drug support was more significant at 12 months, especially on cardiovascular function, blood pressure, muscle strength, muscle endurance, sleep function, dietary compliance, and fitness.

References

De Oliveira, M. P. B., Pereira, D. S., da Silva, S. L. A., Alencar, M. A., Iunes, D. H., & da Silva Alexandre, T. (2023). Are assessment measures for components of the International Classification of Functioning, Disability and Health reproducible for use on pre-frail and frail older adults? A systematic review. Experimental gerontology, 182, 112300. https://doi.org/10.1016/j.exger.2023.112300

Earde, P. T., Praipruk, A., Rodpradit, P., & Seanjumla, P. (2018). Facilitators and Barriers to Performing Activities and Participation in Children with Cerebral Palsy: Caregivers' Perspective. Pediatric physical therapy: the official publication of the Section on Pediatrics of the American Physical Therapy Association, 30(1), 27–32. https://doi.org/10.1097/PEP.0000000000000459Golod N. (2023). Dynamics of the level of risk of falls in elderly patients after laparoscopic cholecystectomy at the subacute stage of rehabilitation. Rehabilitation and Recreation, (17), 39–47. https://doi.org/10.32782/2522-1795.2023.17.5

Golod N. (2023). Dynamics of the level of risk of falls in elderly patients after laparoscopic cholecystectomy at the subacute stage of rehabilitation. Rehabilitation and Recreation, (17), 39–47. https://doi.org/10.32782/2522-1795.2023.17.5

Golod N. (2023). The effect of physical therapy on the external respiratory function of elderly patients after laparoscopic cholecystectomy in the acute stage of rehabilitation. Rehabilitation and Recreation, (16), 16–23. https://doi.org/10.32782/2522-1795.2023.16.2

Golod, N., Buhaienko, T., Imber, V., Kara, S., Zastavna, O., Prysiazhniuk, O., & Kravchuk, M. (2022). The Results of the Examination of Patients After Laparoscopic Cholecystectomy in the Acute Period of Rehabilitation Using the International Classification of Functioning. Acta Balneologica, 3(278), 222–229. https://doi.org/10.36740/ABAL202203104

Golod, N., Saienko, V., Liannoi, M., Rusyn, L., Yaniv, O., & Ivanovska, O. (2024). The dynamics of recovery of external breathing function in patients after laparoscopic cholecystectomy in the acute period under the influence of the rehabilitation program. Wiadomosci lekarskie (Warsaw, Poland: 1960), 77(2), 208–213. https://doi.org/10.36740/WLek202402104

Heerkens, Y. F., de Weerd, M., Huber, M., de Brouwer, C. P. M., van der Veen, S., Perenboom, R. J. M., van Gool, C. H., Ten Napel, H., van Bon-Martens, M., Stallinga, H. A., & van Meeteren, N. L. U. (2018). Reconsideration of the scheme of the international classification of functioning, disability and health: incentives from the Netherlands for a global debate. Disability and rehabilitation, 40(5), 603–611. https://doi.org/10.1080/09638288.2016.1277404

Huang, Y., Wang, Y., Yang, J., Johansson, L., Ma, B., Zhang, X., Lu, Q., Wang, Y., & Zhao, Y. (2023). Application of the International Classification of Functioning, Disability and Health (ICF) in dementia research and practice: A scoping review. Aging & mental health, 27(2), 357–371. https://doi.org/10.1080/13607863.2022.2053835

International Classification of Functioning, Disability and Health (ICF). (2001). Geneva, Switzerland: World Health. Retrieved from: https://bit.ly/3CIbvZ8

Kane, J., Landes, M., Carroll, C., Nolen, A., & Sodhi, S. (2017). A systematic review of primary care models for non-communicable disease interventions in Sub-Saharan Africa. BMC family practice, 18(1), 46. https://doi.org/10.1186/s12875-017-0613-5

Kawamata Y, Fujii R, Hosoya M, Harada M, Yoshida H, Miwa M, Fukusumi S, Habata Y, Itoh T, Shintani Y, Hinuma S, Fujisawa Y, Fujino M (2003). "A G protein-coupled receptor responsive to bile acids". J. Biol. Chem. 278 (11): 9435–40. https://doi.org/10.1074/jbc.M209706200

Litt, J. S., Alaimo, K., Harrall, K. K., Hamman, R. F., Hébert, J. R., Hurley, T. G., Leiferman, J. A., Li, K., Villalobos, A., Coringrato, E., Courtney, J. B., Payton, M., & Glueck, D. H. (2023). Effects of a community gardening intervention on diet, physical activity, and anthropometry outcomes in the USA (CAPS): an observer-blind, randomised controlled trial. The Lancet. Planetary health, 7(1), e23–e32. https://doi.org/10.1016/S2542-5196(22)00303-5

Loozen, C. S., van Ramshorst, B., van Santvoort, H. C., & Boerma, D. (2017). Early Cholecystectomy for Acute Cholecystitis in the Elderly Population: A Systematic Review and Meta-Analysis. Digestive surgery, 34(5), 371–379. https://doi.org/10.1159/000455241

Madden, R. H., Dune, T., Lukersmith, S., Hartley, S., Kuipers, P., Gargett, A., & Llewellyn, G. (2014). The relevance of the International Classification of Functioning, Disability and Health (ICF) in monitoring and evaluating Community-based Rehabilitation (CBR). Disability and rehabilitation, 36(10), 826–837. https://doi.org/10.3109/09638288.2013.821182

Meiqari, L., Al-Oudat, T., Essink, D., Scheele, F., & Wright, P. (2019). How have researchers defined and used the concept of 'continuity of care' for chronic conditions in the context of resource-constrained settings? A scoping review of existing literature and a proposed conceptual framework. Health research policy and systems, 17(1), 27. https://doi.org/10.1186/s12961-019-0426-1

Parry, S. M., Granger, C. L., Berney, S., Jones, J., Beach, L., El-Ansary, D., Koopman, R., & Denehy, L. (2015). Assessment of impairment and activity limitations in the critically ill: a systematic review of measurement instruments and their clinimetric properties. Intensive care medicine, 41(5), 744–762. https://doi.org/10.1007/s00134-015-3672-x

Pasanisi, P., Gargano, G., Gaetana Di Mauro, M., Cortellini, M., Casagrande, A., Villarini, A., Bruno, E., Roveda, E., Saibene, G., Venturelli, E., & Berrino, F. (2018). A randomized controlled trial of Mediterranean diet and metformin to prevent age-related diseases in people with metabolic syndrome. Tumori, 104(2), 137–142. https://doi.org/10.5301/tj.5000599

Peery, A. F., Crockett, S. D., Barritt, A. S., Dellon, E. S., Eluri, S., Gangarosa, L. M., Jensen, E. T., Lund, J. L., Pasricha, S., Runge, T., Schmidt, M., Shaheen, N. J., & Sandler, R. S. (2015). Burden of Gastrointestinal, Liver, and Pancreatic Diseases in the United States. Gastroenterology, 149(7), 1731–1741.e3. https://doi.org/10.1053/j.gastro.2015.08.045

Peery, A. F., Crockett, S. D., Murphy, C. C., Lund, J. L., Dellon, E. S., Williams, J. L., Jensen, E. T., Shaheen, N. J., Barritt, A. S., Lieber, S. R., Kochar, B., Barnes, E. L., Fan, Y. C., Pate, V., Galanko, J., Baron, T. H., & Sandler, R. S. (2019). Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2018. Gastroenterology, 156(1), 254–272.e11. https://doi.org/10.1053/j.gastro.2018.08.063

Population health indicators and use of health care resources in Ukraine. Data from the Public Health Center of the Ministry of Health of Ukraine (2023) http://medstat.gov.ua/ukr/MMXXIII.html

Prodinger, B., Stucki, G., Coenen, M., & Tennant, A. (2019). The measurement of functioning using the International Classification of Functioning, Disability and Health: comparing qualifier ratings with existing health status instruments. Disability and rehabilitation, 41(5), 541–548. https://doi.org/10.1080/09638288.2017.1381186

The Lancet Gastroenterology Hepatology (2023). Tackling the burden of digestive disorders in Europe. The lancet. Gastroenterology & hepatology, 8(2), 95. https://doi.org/10.1016/S2468-1253(22)00431-9

Tsai, C. H., Wu, J. S., Chang, Y. F., Lu, F. H., Yang, Y. C., & Chang, C. J. (2014). The number of metabolic abnormalities associated with the risk of gallstones in a non-diabetic population. PloS one, 9(3), e90310. https://doi.org/10.1371/journal.pone.0090310

Veneri, D., Gannotti, M., Bertucco, M., & Fournier Hillman, S. E. (2018). Using the International Classification of Functioning, Disability, and Health Model to Gain Perspective of the Benefits of Yoga in Stroke, Multiple Sclerosis, and Children to Inform Practice for Children with Cerebral Palsy: A Meta-Analysis. Journal of alternative and complementary medicine (New York, N.Y.), 24(5), 439–457. https://doi.org/10.1089/acm.2017.0030

Zhang Z., Henzel W.J. (2004). Signal peptide prediction based on analysis of experimentally verified cleavage sites. Protein Sci. 13: 2819—2824. https://doi.org/10.1110/ps.04682504