Effectiveness of rehabilitation of elderly people after cholecystectomy in outpatient settings
Authors:   Ivano-Frankivsk National Medical University, Golod Nataliya , Buhaienko Tetiana ,   Sumy State Pedagogical University named after A.S.Makarenko, Rusyn Ljudmyla ,   Uzhhorod National University, Salatenko Ivan ,   Sumy National Agrarian University
Published: November 2024

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.